Claims & Settlement
Claims that assemble themselves
Each insured invoice splits into the patient's co-pay and the insurer's share. The insurer's side accumulates on a claim that you submit, track and settle.
What it does
Built into the day-to-day
- Claims built from what was actually billed
- Lifecycle: draft, submitted, approved, paid, rejected
- Claimed against approved, line by line
- Settlement posts income and the TPA fee separately
- Patient and insurer balances tracked apart
- Outstanding claims visible at a glance
Where the work happens
The forms and views behind it
The screens your staff actually use to run this, and what each one saves them.
Every claim and its state
Submitted, approved, paid and rejected in one list, you always know what is owed.
Claimed against approved
Line by line, with the invoice behind each, differences are visible, not buried.
Questions
Frequently asked
What happens when an insurer rejects a line?
The difference falls back to the patient account rather than silently disappearing, so your receivables stay true.
Are TPA fees handled?
Yes. On settlement the administration fee posts as an expense alongside the income, so the net position per insurer is visible.
More in Insurance & Claims
Related capabilities
See Claims & Settlement working
The live demo is a fully loaded facility. Open it and use this feature with real data.