What this is, and who it is for

Every time an insurer pays a physician group, it sends an electronic remittance, the payer’s remittance file (an X12 835), explaining what it paid, what it adjusted and why. Most groups post these payments and move on. The money that did not arrive gets noticed late, or never.

The Payer Remittance Bridge reads those files, matches every paid claim back to what was billed, checks the payment against the contracted rate, and explains each denial in plain language with the date the chance to fix it runs out.

It is built for the central billing team that works claims for every site, and for the practice managers at each site. The demo customer is Ridgeline Health Partners, a multi-specialty physician group with 6 sites and 14 providers; this demo covers 12 of its billing providers. Everything here is fictional: 4 invented payers, synthetic files, no patients.

Each step’s button signs in as the right person and opens the page it describes: Dana Whitfield, the billing lead; Marcus Okafor, a practice manager; Renee Alvarez, who manages the East Region; and, on the last step, Kendra Hollis, who bills for the West Region. You can also switch person yourself at the top of any page. The whole tour takes about five minutes.