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Insurance and billing

Real-time eligibility, claim scrubbing, denial triage. One workspace, six tabs.

Revenue cycle inside the same workspace as documentation. Signed encounters with ICD-10 codes auto-create claims. Eligibility runs before booking. Denials surface with the next action attached, not buried in a queue.

Six tabs, end to end

Dashboard, claims, eligibility, reports, enrollment, and a workspace ledger.

Each tab is a different surface against the same data. The dashboard is the read. Claims is the queue. Eligibility is what you check before scheduling. Reports is what you bring to ops review. Enrollment is the credentialing matrix. Ledger is the financial source of truth across every patient and payer.

Total billed
$248.6k
+8.2%vs last 30 days
Total collected
$214.9k
+11.4%vs last 30 days
Outstanding
$33.7k
-4.1%vs last 30 days
Denied
$6.2k
-2.7%vs last 30 days
Status distribution412 claims, last 30 days
  • Paid 62%
  • Submitted 17%
  • Pending 9%
  • Partial 7%
  • Denied 5%
Collection trend12 weeks, $k collected
$67.0k+24% over the quarter

Stylized for marketing. The live workspace renders the same surfaces against your patient and payer data, with per-claim actions on every row: view detail, resubmit, appeal, mark as paid.

Claim status flow

From signed encounter to paid claim, with denials handled in line.

Claims are auto-generated from signed encounters that have ICD-10 codes assigned. The happy path is short. The denial path is short too, because the next action is part of the row.

  1. Pending
  2. Submitted
  3. Accepted
  4. Paid
  1. Denied
  2. Appeal
  3. Resubmit
  4. Paid

Partially paid is its own status, not a forced choice between paid and denied. The workspace tracks remaining balance against the original line items so the patient ledger and the claim agree.

Insurance coding

Insurance coding configuration.

Tune how AriaMD suggests codes across the workspace, without editing per-encounter settings.

The Insurance Coding sub-section under Settings, Tools and AI gives admins three workspace-wide controls. Default ICD-10 code sets cover the most common diagnoses for the practice, so suggestions stay relevant for the work clinicians actually do. The confidence threshold tunes how aggressive AriaMD is: lower values surface more candidates and let the clinician filter, higher values keep the list short and only offer codes the model is confident in. Specialty-specific rules add or restrict codes for groups that standardize documentation policy across providers.

Groups that want consistent coding behavior across new providers benefit from workspace-wide defaults, and solo practices can nudge AriaMD toward their own panel without retraining anything.

Eligibility before you book

Real-time verification, with the answers that change a treatment plan.

Run eligibility against the payer at scheduling, at intake, and on demand. The response surfaces the values that decide whether a patient can see you next week or needs to wait on prior auth.

Running eligibility S.R., Aetna Behavioral Health
Patient S.R.
Member W••••3284, group 0042
Aetna Behavioral Health
PPO Behavioral Health
Active
  1. CoverageActive
  2. Deductible$750 of $2,500 met
  3. Copay$30 per visit
  4. Out-of-pocket max$4,200 remaining
  5. Covered services90791, 90834, 99213, J0177
Verified in 1.2 s270101 X12 EDI 270/271
Credentialing and enrollment

Provider and payer participation, in the same matrix the billing team already uses.

Each provider has a row per payer. Active, pending, and not enrolled states drive whether a claim can ship today. Effective dates and credentialing contacts live on the row, so re-credentialing windows are not a surprise.

Provider NPI
1659••3214
Pulled from Settings, Clinic.
Payer
Aetna Behavioral Health
Network and panel scope per row.
Enrollment status
Active
Active, pending, or not enrolled.
Effective date
2025-08-14
Drives claim eligibility windows.
Service locations

Assigned per encounter. Drives location-based coding rules.

Service location is set on each encounter, not on a clinic-wide default. The assignment changes which place-of-service code rides with the claim, and which payer rules apply. Telehealth and in-office bills do not look the same on the wire.

Service Location Assigned is also an automation event. You can wire AriaMD to run a custom prompt the moment a location lands on an encounter, for billing checks, location-specific compliance, or routing into the right ledger view.

See automations and event triggers
See it on a real claim

Twenty minutes. We sign a sample encounter, watch the claim materialize, and walk eligibility against a real payer.

The point is not the screen. The point is the cycle: from signed note to paid claim, denial path included, in the same workspace your clinicians already use.

Book a 15-min demo with Ryan Talk to sales
Live in 2 weeks or less BAA signed by default 30-day money back