Your billers still key every claim,then chase it by hand.AI automation for medical billing companies and practice billing offices, built on the systems you bill in. Your team gets its hours back, the money comes in sooner, and every step is on the record.
HAIBRID Consulting builds the systems that do your office’s routine claim work, from the front desk to the bank.
Your billers spend their day on the claims that need their judgment, and more of what you bill gets paid.
One claimFollow claim 20417 from the insurance card to the posted payment.
Four things have to go right before it is paid in full, and today each one costs your office hours or money.
Example · Claim 20417 · Injection, prior authorization required
Claim 20417 drawn as a loop. It starts at the front desk with the insurance card, crosses the biller’s desk where the superbill becomes the claim form, and leaves through the clearinghouse into the payer, drawn as a blank wall. It comes back as a remittance: paid in full runs on to the bank and the report; paid short and denied turn back through the queue and go out again as an appeal. At each stop what goes wrong today drops off the loop, some of it into a tray marked written off, and what we build closes it. A log strip under the loop gains a line at every stop.
Example · Claim 20417
The record · Claim 20417
Mon 07:40SystemCoverage active. Auth A-4471 approved and filed
Mon 09:12SystemSuperbill read. Units sent to a biller
Mon 09:20J.R.Units confirmed. Claim sent
Thu 06:05SystemBilled 99214, paid as 99213. Flagged
Thu 08:31SystemAppeal drafted from the record
Thu 09:02M.K.Appeal approved and sent
Mon 07:00SystemPaid, posted, tied to the deposit
1Coverage is checked and the authorization is chased
Today
A biller signs in to one payer site after another, reading benefits off the screen and typing them in. The authorization is faxed and chased by phone, and when it comes through, nobody tells the person who bills the claim.
What we build
Coverage is checked electronically for every patient on the schedule, and your team sees only the ones that come back inactive, changed or empty. An agent, software that uses AI to work out its next step inside limits you set, watches every pending authorization, flags the day one is approved, denied or about to expire, and files the number where the claim will need it.
We measure
Visits verified before the patient arrives, and denials for a missing authorization.
2The charge is keyed and the claim goes out
Today
Every charge and every patient’s details are keyed by hand, a couple of minutes at a time, and a rejection comes back days later as a bare code.
What we build
AI reads the superbill, rounding sheet or face sheet however it arrives, typed, handwritten, faxed or photographed, and rates how sure it is of every field. What it is sure of goes into your billing system; the rest goes to a biller with the source page. Fixed rules check the claim against that payer’s requirements, so claim 20417 cannot leave without its authorization number, and a rejection comes back in plain words with the fix.
We measure
Charges keyed by hand, days from visit to claim, and claims accepted on the first pass.
Example · Claim 20417
3The payment comes back and is posted
Today
Remittances your system will not post are matched by hand, line by line, and month-end waits on them. A 99214 paid as a 99213 goes through unless someone happens to catch it.
What we build
Every remittance, electronic or paper, is matched to its claims line by line. Clean matches post on their own; a mismatch goes to a person with the reason attached. Each line is checked against that payer’s fee schedule, so a downcode or a short payment is flagged the day it arrives.
We measure
Payments posted without a touch, and dollars paid below what was billed.
Example · Claim 20417
4The denial is worked and the unpaid claim is chased
Today
On Friday someone exports each system’s denials into a color-coded workbook. Claim 20417, denied for a missing authorization, lands behind a filter and resurfaces with its appeal window nearly shut. Unpaid claims are worked oldest first, one call at a time.
What we build
One queue holds every denial and unpaid claim from every system you work in, ranked by what is recoverable, with its reason in plain words and the days left to appeal or file. Claim status is checked with the payers on a schedule. For a denial, the system gathers the notes, the payer’s policy and the claim’s history and drafts the appeal; your biller edits, approves and sends it.
We measure
Denials worked before their deadline, denied dollars won back, and dollars more than 90 days old.
Example
That is one claim. Your office runs the same loop on every claim, for every payer, every day.
We build the loop as one system, from three of our services. Workflow Automation does the reading, the checking, the watching and the chasing. Systems Integration moves the data between the practice’s records, your billing system, the clearinghouse and the bank, so nothing is keyed twice. Business Intelligence reads denial rate and net collections by payer, provider and client, and answers plain questions, like which payer downcoded the most office visits since January.
You take on providers and clients without adding billers at the same pace, and the money arrives sooner.
Checked and loggedEvery claim the system touches leaves a record you can hand to an auditor.
Your office answers to its clients, the payers and HIPAA, so the controls are designed with you and written down before the build starts.
The record of claim 20417 as a ledger page: one row per step, each with its date stamp, a mark for who acted (a gear for the system, pencilled initials for a person), what was done, and a thumbnail of the page it came from. Under the page sit two switches the office holds: one set to review everything or review exceptions, and an off switch.
Example · Claim 20417
Claim 20417 · The recordBAA
StampWhoWhat was doneSource
1Coverage active · auth A-4471 filed
2Superbill read · units to a biller
2J.R.Units confirmed · claim sent
399214 paid as 99213 · flagged
4M.K.Appeal approved · sent
5Paid · posted · tied to deposit
Accountable · named in writing
Review everythingReview exceptions
Off
Your own documents set what goes through
We test each build on a fixed set of your own documents with the answers already known, and that test sets the line. Above it, work goes through on its own. Below it, the item waits for a biller with the reason attached. You decide when to move from reviewing everything to reviewing exceptions, and you can move back. Adjustments, write-offs and appeals always keep a person’s yes.
Every step can be traced
The log shows what was read and from which page, which rule checked it, and what was changed, by the system or by which person, and when. Pull one claim and you can follow it from the superbill to the deposit. Each build signs in under its own named account, sees only the fields its job uses, and at a payer works as the practice’s registered delegate, never on a biller’s password. Every account can be switched off in one place.
Patient data stays under agreement
We sign a business associate agreement before we see a patient record. If you are a billing company, we work under yours as a subcontractor, so there is no new contract with every practice you serve. The AI runs only on services that have signed the same kind of agreement, keep no patient data after the job and never train on it. You decide where the system runs, and the contract says what each of us answers for and who at HAIBRID is accountable for regulated data.
Your numbersThe three numbers that cost a billing office most.
Before we build, we count yours from your own billing system, your remittances and your team’s day.
1
Prior authorization, hours a week
13 hrs
yours
Physician and staff time every week, in a survey of 1,000 physicians. Two physicians in five have staff who work only on it.
AMA prior authorization survey, 2025
2
Claims denied on first submission
7 to 8%
yours
Where the rate has held for four years. Under 5% is within reach of a practice that fixes its process.
MGMA
4
Denied claims paid on appeal
About70%
yours
Premier’s 2025 survey of 280 hospitals: about 70% of denials were overturned and paid after appeal, at about $57 a claim (2023). The money goes to the offices that get to every one in time.
Your kind of officeWhat we build for billing companies, practice offices and groups.
Billing companies
Every client is a different system and a different login, and your billers get one queue across all of them. A new client’s providers, payers and fee schedules load from the files they send, not retyped, and each client’s month-end report builds itself from the claims. Credentialing is tracked payer by payer: every application, every follow-up date, every CAQH re-attestation on a clock.
Practice billing offices
Coverage is checked again each January when deductibles reset, before the patient reaches the front desk. Patient statements go out once insurance has paid, with reminders that stop when the balance clears. And if an outside company works your claims, your own claims data shows you what was billed, what was collected and what is still open.
Groups and management companies
Several practices on several systems, compared side by side, practice to practice and payer to payer. For a group with an investor behind it, the same read runs across every practice and lands in one report.
Why HAIBRID, for a billing officeThe reading and the entering already run in systems we built.
You will not spend the first call explaining the difference between a rejection and a denial. Our founder began his career in financial operations at a large health insurer, the payer’s side of every claim you file.
One of ours · Step 22
Superbills and rounding sheets, read at 99.8% of fields
We built a reading and review bench for this market and ran 20 synthetic test superbills and hospital rounding sheets through it: clean, handwritten-style and deliberately degraded. Of 620 fields it read 99.8% correctly. The one field it misread, it flagged for a person, so nothing wrong went through marked as sure. Your own documents are the next test.
One of ours · Step 22
A scanned report entered into case software in about 23 seconds
A build of ours reads a scanned accident report, rates how sure it is of every field, and fills 18 fields in a law office’s case software in about 23 seconds on average across the reports we tested. By hand that intake takes 30 to 60 minutes. Moving a charge from a rounding sheet into your billing system is the same job: read, rate, enter, and send the doubtful field to a person.
“We already pay for a billing system and a clearinghouse. Why isn’t that enough?”
Your system catches the error and holds the claim. Someone still has to open the list, fix the claim, chase the payer and notice the short payment, and an office working in five systems still merges five reports in a spreadsheet. We switch on what you already pay for and build the rest around it.
“Each of our clients is on a different system. Does this work with them?”
Yes. We work with athenahealth, eClinicalWorks, AdvancedMD, Tebra, NextGen, CollaborateMD, DrChrono and Office Ally, and with clearinghouses including Waystar and Availity. We connect through the system’s own data connection where it offers one, through the standard claim and remittance files where it does not, and through its screens when that is the only way in.
“I tested this myself with a chatbot and it read the sheet. Why do I need you?”
You proved the reading works, and you are right. The job is everything around it: running it under an agreement that covers patient data, testing it on a few thousand of your real charges, entering the checked data into your billing system, catching the ones it gets wrong, and keeping it running when a payer changes a form. That is what we build.
“What does it cost?”
It is a project with an end, priced against a number from your own office: the hours of keying it takes back, the denied dollars it recovers, or the hire you would otherwise make. You own what we build, so you are not paying a share of your collections for it. The Proof Sprint is a short, paid first phase, and it ends with a build working on your own claims before you commit to the rest.
“Who keeps it running when a payer changes its rules?”
Payer rules live in a list your team can read and edit, not buried in code. We hand the build over working, with a written record of how a claim ran before and how it runs now, keep watch for 60 days, and you own all of it, including the code.
Find out what your office still keys, checks and chases by hand.
Get your Operations X-ray, our free first look at your operation. Or book a call and walk us through one claim.
