Insurance and revenue
Medical claims management software that files clean the first time.
Every claim built, scrubbed, filed and reconciled against what the payer paid.
Claims desk, this morning
Clean claim rate
97.8%
first pass, last 30 days
Filed today
142
137 accepted on 277CA
Dollars in flight
$68,410
filed, not yet paid
Underpayments flagged
6
$1,184 below contract
Where today's claims are
Every figure links to the claims behind it in your PMS.
Clinics lose a meaningful share of revenue to claims that go out wrong, get paid short, or never get looked at again. Clean claims and full reconciliation stop that leak at the source.
Scrubbed
against payer rules before anything is filed
Every line
of the remittance reconciled
Claim scrubbing
Every claim is checked against payer rules before it leaves.
Claim scrubbing runs on each claim as it is built, not as a batch at the end of the week. Anything that fails is held with the reason attached.
CLM-48213 · Maria L. · 99214-25, 90471
Result
Clean, ready to file
All five checks passed. Queued for the 837P batch at 2:00 pm.
From the visit to the bank
One claim, followed through seven handoffs.
CLM-48213 lifecycle
- 1PMS
Charge captured
Checkout, Mon 10:42
- 22care
Built
Codes, modifiers, auth
- 32care
Scrubbed
5 of 5 rules passed
- 4EDI
Filed 837P
Batch 2:00 pm
- 5EDI
Accepted 277CA
Tue 06:15
- 6835
Paid
$148.32 on day 14
- 7PMS
Posted 835
Lines reconciled
Typical commercial payment lands 14 to 30 days after a clean submission.
Built from the charge
The claim starts from the charges posted at checkout, with the visit's codes, provider, location and payer details pulled in.
Filed and acknowledged
Clean claims go out as 837P files. The 277CA that comes back is read line by line, and a front-end rejection is fixed and refiled the same day.
Paid and posted
When the 835 arrives, payment and adjustments are written against each line in your PMS, and the patient's share moves to their balance.
The difference
The same week of claims, two ways.
Nothing on the left is careless. It is what happens when one biller has 600 claims and the same eight hours as everyone else.
Worked by hand
Worked by 2care
When errors are caught
When the rejection comes back, days later
Before the claim is filed
Secondary claims
Filed when someone notices the primary paid
Filed the day the primary's 835 posts
Short payments
Posted as paid, difference written off
Compared with your fee schedule and flagged
Front-end rejections
Found in a clearinghouse report nobody opens
Read from the 277CA, fixed and refiled
What your biller spends the day on
Keying, posting and checking
Coding questions, appeals and payer disputes
Remittance posting
Payments posted line by line, with the gaps called out.
Remittance posting is where short payments hide. Each 835 line is matched to the line billed and checked against what your contract says the payer owes.
835 posting · Commercial PPO · check 0041872
| Line | Status |
|---|---|
| 99214-25 | Working |
| 90471 | Working |
| 90686 | Working |
| 99396 | Working |
| 36415 | Working |
99396 allowed $141.20 against a contracted $163.00. Sent to billing with the contract line.
Who decides what
The paperwork moves on its own. Judgement calls do not.
Claims touch coding and contracts, and both carry compliance weight. 2care handles the volume and leaves the decisions that need a licence or a signature with your team.
2care does
- Build claims from posted charges and visit details
- Run payer rule checks and hold anything that fails
- File 837P claims and read every 277CA
- Post 835 remittance and reconcile each line
- File the secondary claim once the primary pays
- Flag underpayments with the contracted figure attached
Your billing team decides
- Changing a code or level the provider documented
- Writing off a balance without an approved reason
- Accepting a payer's short payment as final
- Billing a service the chart does not support
Every hold, flag and write-off request shows the rule or remittance line behind it, so a reviewer can agree or overrule in one click.
After the primary pays
Secondary claims go out the day the first plan settles.
Secondary balances are the easiest money to leave behind, because nobody is waiting on them. Here they are filed automatically with the primary's payment data attached.
James O. · visit 09/03 · two plans
Primary filed
837P09/03Commercial PPO, $240.00 billed
Primary paid
83509/19$141.20 allowed, $112.96 paid, $28.24 coinsurance
Secondary built
09/19Primary payment and adjustments attached
Secondary filed
837P09/19State Medicaid, $28.24 requested
Awaiting secondary payment
277CA09/20Accepted on 277CA, status check set for day 21
Patient statement
Held until the secondary settles
See it work
The call your billing team keeps putting off
A pending claim chased with the payer: the status, the missing records, where to send them, and a reference number logged on the claim.
Insurance and revenue
The rest of the workflow.
Claims, plainly
Questions billing leads ask about handing over claims.
It handles a claim from the posted charge to the posted payment: building it, checking it against payer rules, filing it, reading the acknowledgment, posting the remittance and following up on anything short or stuck. 2care does that inside your existing PMS rather than in a separate billing system.
No. 2care works through the systems you already use, across 95+ integrations and EHRs. Claims are filed through your existing connection and every result is written back where your team already looks.
Clearinghouse edits mostly check format. Claim scrubbing here also checks payer-specific rules and the visit itself: whether the auth is attached, whether the payer order is right, whether modifier 25 is needed, and how many days are left to file.
No. If documentation looks thin for the level billed, or a code pairing looks likely to deny, the claim is held and flagged for your coder. The code itself only changes when a person changes it.
Each 835 line is posted with its allowed amount, payment and adjustment codes. If the allowed amount is below your contracted rate, the line is flagged as a variance instead of being written down silently.
Yes. Dental claims use CDT codes and the 837D format, with the same scrubbing, filing and posting steps. Primary care and dental are the two settings 2care is built for first.
They move straight into denial recovery, where each denial is read by its reason code and sorted into fix and resubmit, appeal, or write off with a reason your team approves.
Built for regulated healthcare, in every market we operate in
HIPAA
United States
BAA available on request
GDPR
UK & Europe
DPA available, data hosted in the EU/UK
DPDP
India
Data residency in India
See your claims worked end to end. Book Demo.
30 minutes, on your own workflows. No commitment.
- 95+ integrations and EHRs
- ·Live in weeks, not months
- ·HIPAA, GDPR and DPDP