Funding claims and rebates require manual data gathering, form completion, and payment reconciliation across multiple funder portals and systems. Manual processing creates delays, errors, and scattered documentation that slows cash flow and increases compliance risk.
Automation extracts patient data, populates claim forms, tracks submissions, and reconciles rebate payments in a centralized register. The result is faster claim processing, fewer missed deadlines, and accurate rebate allocation to patient accounts.
The full workflow, from trigger to completion.
Automation is triggered when a claim deadline approaches (via calendar sync), a new funder contract is signed, or a rebate payment is detected in the bank feed.
The automation queries the practice management system and clinical records to pull patient demographics, session dates, diagnoses, and treatment codes for the claim. Data is validated and formatted.
The automation checks that required consent forms and clinical summaries are present and current. If any document is missing, the workflow pauses and notifies the compliance officer.
The automation populates the funder's claim form (PDF or web portal) with patient data, session counts, fees, and clinical codes. Form templates are stored for each funder.
The automation retrieves and attaches consent forms, clinical notes, and invoices from cloud storage and email to the claim submission.
The automation submits the claim via email or funder portal and logs the submission date, claim reference number, and funder details in a centralized claim register.
The automation periodically queries funder portals or checks email for status updates and logs approvals, rejections, or requests for additional information. notifications alert the team to status changes.
When a rebate payment is received, the automation matches it to the original claim, creates a credit memo, and allocates the rebate to the correct patient accounts based on claim data.
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