Revenue cycle software for medical practices and billing companies. Every claim is checked against NCCI, Medicare and your payers before it goes out, and every dollar is followed to your bank.
Built for the organizations that bill for care
One to ten providers, carrying the same regulatory load as a hospital with none of the staff.
Different fee schedules, authorization rules and denial patterns per specialty, in one ledger.
Many practices side by side, each needing its own reporting and its own reconciliation.
High volume, thin margins, and a payer mix weighted toward Medicaid and sliding-scale patients.
Claims in the format every payer reads. The platform generates 837P claims with the payer IDs for Medicare Part B, state Medicaid programs and the major commercial plans, and posts their 835 remittances. Live submission to payers runs through a connected clearinghouse.
Inside the live demo environment
Most billing problems are caught too late. CollaboratMD moves every check forward, to the moment the claim is created, and follows the money all the way to your bank statement.
Eligibility runs for tomorrow's whole schedule in one pass, and patients update their own details before they arrive.
Illustration of the screen with sample figures
Every suggestion comes with its reasons. Where AI is used, it is given codes, not people: names, dates of birth and member IDs are filled in on our side after the AI has answered.
What the AI never sees
Patient names, dates of birth, member IDs or addresses, for denial explanations, appeals and data imports. Visit notes, which do contain patient information, are sent only if the practice turns that on after signing a BAA.
Each unsent claim is scored from your own last 12 months with that payer, plus known warning signs like a missing authorization number or an unverified policy. Every point comes with its reason, so you fix the cause instead of trusting a number.
CARC and RARC codes become what happened and what to do next. Codes alone go to the AI, and a built-in explanation is used when no AI key is configured.
A letter for the denial reason, filled with the claim, patient and practice details. With AI on, the argument is written from codes only and patient details are added afterwards on our side.
Visit level by the AMA time and medical decision making rules, and a diagnosis finder that understands everyday words. AI coding of full visit notes stays off until the practice has a BAA with the AI provider.
Every claim in flight is projected from how that payer has actually paid you: how often, how much and how fast, adjusted for the claim's age. Scheduled visits and patient payments are added, and the method is on the page.
Each payer's last 30 days are compared with its previous 90: more denials, slower payment, lower payment or a denial reason that suddenly spikes. Alerts need real volume, so noise stays out.
Each balance says why in plain English or Spanish, from the payer's own reasons: deductible, coinsurance, copay, not covered. Estimates use the deductible left today, and patients get a year-end receipt for their HSA or taxes.
Each payer contract's renewal and notice dates, with reminders before the notice window closes, next to what that payer underpaid you and allowed per code, so you go into the negotiation with numbers.
Close a month and it is locked: nothing can be posted into it afterwards, so the numbers you sent your accountant stay true. The A/R rollforward has to reconcile to the cent before you close.
Rejections and denials caused by a wrong member ID, name or date of birth are traced back to the field and to who entered it, so the front desk fixes the pattern, not just the claim.
Two charts for the same person are found by name and birth date, member ID or phone, and merged in one step with every visit, claim and payment moved across.
Every write-off records its reason, and avoidable ones (late filing, no authorization, coverage not checked) are shown by payer, month and person, apart from contractual adjustments.
Name a parent as guarantor and the children's statements go to them, the family's balances are shown together, and one payment is spread across everyone's visits.
Cash, checks and card batches counted against what was posted that day, by payment method. A difference needs an explanation before the deposit goes to the bank.
No-shows and late cancellations are charged only under a policy the patient agreed to first, never to insurance or Medicaid patients, and can be waived with a reason.
Each denial is traced to its root cause and the team that can prevent it (front desk, coding, documentation or billing), with the preventable share month by month.
Agency payments post in full to the patient's account and the commission is booked on its own, so cash matches the check. See which agency actually recovers more.
Percentage of collections, dollars per work RVU, or a base with a bonus: each provider's pay for the period from the same numbers as the rest of your reports.
Copays and old balances collected at check-in against what was due, by location, week and staff member: the cheapest dollar you will ever collect.
Returned mail stops statements to a dead address until it is fixed, and grown children stop receiving bills through their parents unless they agree.
Ask how each new patient heard about you, then see new patients, visits and collections by source and by referring physician.
Enter what billing costs each month and see it as a share of what you collect, with agency commissions counted for you.
An itemized superbill with codes, diagnoses, NPI and tax ID for patients who file with their own out-of-network plan, from any visit.
Saved cards about to expire are found before a charge fails; the patient replaces the card from a text without paying anything, and autopay carries on.
Split statements into two or four cycles by last name, so payments and phone calls are spread across the month instead of arriving in one wave.
Medicare and Medicaid have rules commercial payers do not, and deadlines that carry penalties. CollaboratMD applies them on every claim and every payment, says which rule each warning comes from, and runs the compliance habits an auditor looks for: answering requests on time, asking before billing, and checking your own coding.
Every paid Medicare claim is checked against the physician fee schedule for your locality, at the office or facility rate, with the multiple-procedure reduction. Contracts can be set as a percentage of Medicare.
The Medicare Secondary Payer questions decide the billing order. A claim sent in the wrong order is stopped, and a claim Medicare already crossed over to a supplemental insurer is not billed again.
Record the patient's choice on form CMS-R-131. GA is added to the lines the notice covers, and a claim that contradicts the notice is stopped before it goes out.
Medicare's five levels, from redetermination to federal court, each due the right number of days after the last decision. Other payers follow their own appeal window.
A Medicare or Medicaid overpayment shows the date it must be returned, with a reminder before it passes. Money a payer takes back from a later check is posted to the claim it belongs to.
Place of service and modifiers checked against Medicare's telehealth list, NDCs on drug lines, the 8-minute rule for therapy and minutes for anesthesia.
A visit inside a surgery's 10- or 90-day global period is caught before the claim goes out, with the modifier it needs, and routine follow-ups go in as 99024 at $0.00.
When Medicare's eligibility answer says the patient is in a Medicare Advantage plan, the front desk sees the plan and a claim to traditional Medicare is stopped.
Chronic care management, behavioral health integration and remote monitoring: consent on file, minutes logged through the month, and one claim when it ends.
When the new ICD-10-CM year arrives, you get the codes your practice uses that it deletes or splits, where they sit on open visits, authorizations and lab orders, and what replaces them. Each claim is checked against the codes in force on its date of service.
Medicare denies lab, imaging and equipment claims when the ordering practitioner is not enrolled to order them. The referring NPI is checked against CMS's ordering and referring file before the claim goes out.
ADRs, RAC and TPE reviews are tracked to their due dates and the records sent are logged. Patients' HIPAA requests for their records or an accounting of disclosures run on their 30- and 60-day clocks.
Physical, speech and occupational therapy are totaled per Medicare patient per year. Over the year's threshold, lines without KX are flagged; over the review amount, you are told to check the plan of care.
When a note does not support what was billed, the coder asks the provider from the claim, and the claim waits for the answer instead of going out and coming back denied.
A random sample of each provider's claims, checked against the notes by someone other than the coder, with accuracy against a 95% target: the internal review the OIG's compliance guidance expects.
Mark a dual-eligible patient as a Qualified Medicare Beneficiary and their Medicare deductibles and coinsurance stay off statements, reminders, card charges and collections, as federal law requires.
A chargemaster with revenue codes prices your facility claims and produces the standard charges file hospitals must publish, laid out after CMS's template, with each payer's contracted rate.
A bankruptcy stops every collection step at once, as the automatic stay requires; a death stops billing the patient and turns the balance into an itemized claim against the estate.
Every HIPAA privacy complaint logged, investigated and answered, with mitigation and sanctions recorded and nothing deleted, as the Privacy Rule requires.
A substitute physician's visits go out under the absent provider with Q6 or Q5, the substitute's NPI on record, and Medicare's 60-day limit enforced.
Referral numbers go on the claim with visits counted, and Medicare therapy is checked against a plan of care certified within 30 days and renewed every 90.
Interpreters provided or declined are logged for Section 1557, with upcoming visits that need one and Medicaid T1013 units where your state pays.
Billers in Manila or Karachi work in their own time zone and holiday calendar: night shifts past midnight, whole or part-day time off with leave balances, shift swaps and open shifts, weekly timesheets with corrections, clock reminders, a team week with a workload forecast, daily targets, quality checks, training records, and a pay worksheet with overtime, night and holiday pay in their currency.
Every CMS code set is tracked against its release calendar, so October's diagnosis codes and each quarter's edits are loaded before claims need them, and your fees and contracts are flagged when they fall behind.
Checks built on CMS files (the fee schedule, the telehealth list, ICD-10-CM and HCPCS) run once that year's files are loaded.
Eligibility, coding, claims, remittance, patient payments and reporting share one ledger, so nothing is re-keyed and every dollar can be traced.
needs … = connect the practice's own account
Every screen sits somewhere on this path, and nothing is a dead end: a denial becomes an appeal or a corrected claim, a balance becomes a statement, a payment or a plan.
Book the visit, check coverage for the whole day, and send a reminder with an online check-in link.
Charges priced from your fee schedule, with coding help for the visit level and diagnoses.
Blocking errors stop the claim; the risk score shows what could still get it denied.
837P, 837I or 837D out, acknowledgments in, status inquiries for quiet claims, secondary billed on its own.
835 remittances post by line, deposits match their ERAs, and underpayments are flagged.
Denials become appeals, underpayments become dispute letters, missed visits get billed; balances become statements, portal payments, plans or, last, collections.
Move the sliders to your practice's numbers. The arithmetic is shown under the result, and nothing you enter leaves this page.
All claims the practice sends in a month
Average billed or expected amount per claim
Share of claims denied on first submission
Of the denied amount, the share you end up writing off
Your estimate: time to research, correct and resubmit or appeal
Industry benchmark is under 5%
Denials cost you about
$207,000 / year
$17,250 a month: $13,500 written off and $3,750 of rework on 150 denials
At a 5% denial rate
$103,500 / year back
Denied claims = claims × denial rate. Cost = denied claims × (average value × share never recovered + rework cost). Your own figures, not a promise of results.
A dashboard that reports 51 days in A/R without saying whether that is good is just trivia. Every headline metric is shown against the industry target and colored accordingly. With email connected, a summary arrives every Monday.
See it on a full-size demo practice| Metric | Target |
|---|---|
Days in A/R How long revenue sits uncollected after the visit | Under 40 days |
Net collection rate Share of collectible revenue you actually collect | 95% or better |
Clean claim rate Claims accepted on first submission, without rework | 95% or better |
Denial rate Adjudicated claims the payer refused to pay | Under 5% |
A/R over 90 days Aged receivable that rarely gets collected | Under 15% |
Front desk staff, billers and administrators cost nothing. You pay for the clinicians who generate charges, plus a transaction line tied to claim volume. Pay annually and 2 months are free.
Independent practices, 1 to 5 providers
or $82.50 billed annually
plus $0.30 per submitted claim
Growing and multi-specialty practices
or $124.17 billed annually
plus $0.30 per submitted claim
Billing companies managing multiple practices
or $165.83 billed annually
plus $0.30 per submitted claim
Claims, eligibility, status inquiries, acknowledgments and remittances are generated and parsed as real ASC X12 transactions, and EHR and lab traffic as HL7 v2, all covered by segment-level tests.
Connects to, with your own account, from one settings screen
The demo runs on a full-size synthetic practice: 100 providers, 15,000 patients and 105,000 claims that have been scrubbed, submitted, adjudicated by a simulated payer, denied and appealed, with bank deposits and collection accounts to work through.