Claims are hard. Fortunately, so are we.
Every claim, remittance and bank deposit in one place, so you know when the money should arrive and whether all of it did.
Book a walkthroughThe mess you have now
Five places to look, and none of them tells the whole story.
Whether a claim was accepted, what the payer paid and whether the money reached your bank all live in different systems. claimhard reads them and puts the answer on one screen.
- Clearinghouse statusAccepted or rejected, claim by claim.
- Medicare remittancesWhat Medicare paid, adjusted or denied.
- AvailityRemittances from your non-Medicare payers.
- Your bankThe deposits that actually arrived.
- Your care platformPatients, coverage and care time.
Question one
When do I get my money?
For each accepted Medicare claim, claimhard shows when Medicare should pay it, from Medicare's own timing rules for clean electronic claims: not before day 14 after acceptance, and by day 30.
Beside that, how fast each payer has actually paid you, from your own payment history. It is an expectation, not a promise, so the claims that run past it are the ones to chase.
Question two
Did I get all of it?
Two checks, every night, from the claim to the payer's answer to your bank account.
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Claim to remittance
Each payer's answer is matched to the claim it pays. A remittance that can't be matched is counted and broken down by why (no account number, no claim on that date, a charge that differs), never silently dropped.
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Remittance to bank
Each payment your clearinghouse's remittances say was sent is checked against the deposits that actually reached your bank account, through Plaid. One deposit pays many claims, so the match is per payment: deposited, amount differs, or not yet deposited. Payments read from Availity aren't checked against the bank yet.
What's in it
We do the hard things.
Finding the claims that need a person, working out what a patient owes, and keeping the team told. Six jobs claimhard takes off the pile.
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Rejection worklist
Every rejected claim in one list, with the payer's reason beside it, filtered by line of business, payer or date. Open one and see its full history. The patient's MBI shows as its last four characters until you ask for the rest.
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Patient balances and statements
What each patient owes per Medicare's remittance, and which patients can be sent a statement. Patients who are QMB, or who have a secondary insurance still to pay, are held back from the statement queue. A person prints and mails each statement. Eligibility checks are paid per check and switched on per customer.
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Patient statement portal
Patients open their statement on your own web address after a code and date-of-birth check. It is view only today; online payment is coming.
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Nightly digest email
One short email each morning: yesterday's sent, rejected and paid, and anything that needs a look. No patient details in it.
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AI denial explanations
Click "Explain with AI" on a denied claim and get a plain-English reading of the codes. It is switched on per customer, and it is advice only: it never changes a claim or a rule, and it is never sent anything that names a patient.
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Several billing entities, one login
Run more than one practice or billing number from the same sign-in. Each one's claims, remittances and deposits stay separate, and nothing is ever matched across them.
Who it's built for
Built for CCM and RPM.
Chronic care and remote monitoring bill small amounts, many times a month, on codes that are easy to miss. claimhard shows them the way you think about them.
Every code, by stage and payer
Codes like 99490, 99439, 99487, 99454, 99457 and 99458 (examples, not a list of everything supported), broken down by claim stage and payer, with the units and billed amount each one carries.
Billing runs on a monthly cadence, and the views do too.
Care-platform time against units billed
For CCM, claimhard compares the time your care platform recorded with the units you billed, and flags recorded-but-not-billed and billed-beyond-recorded. It is a flag for a person to check, not a rule.
DME support is on the way.
What it connects to
Slides right into your workflow.
claimhard reads from the systems you already use. It never submits or changes a claim.
- Claim.MDclearinghouse status, claims and Medicare remittances
- Availityremittances for the non-Medicare payers
- Plaiddeposits into your bank account
- Cliniipatients and care-platform time
Don't see yours? We'll build it in days, not months.
Healthcare software moves slowly because it can. We don't.
Who's behind it
Built by operators.
- We run CCM and RPM billing ourselves. claimhard is the tool we needed and couldn't buy.
- We know the system, from Medicare's payment rules and QMB to what an 835 actually says.
- We use it every day, so what's wrong with it gets fixed, and we ship improvements constantly.
Security
HIPAA compliant, and we sign a BAA with every customer.
- Hosted on AWS under a BAA.
- MBIs masked by default.
- Patient identifiers kept out of logs and error reports.
- Every customer's data walled off from every other's.
- AI that advises and never decides.
FAQ
Straight answers.
Do you submit claims?
No. claimhard reads from your clearinghouse and payers and never submits, corrects or deletes a claim.
Do you replace my clearinghouse?
No. You keep the one you have; claimhard sits beside it and reads what it reports.
Can you connect to the system we use?
Probably, and quickly. Tell us what it is.
How long does setup take?
Usually under two weeks.
What does it cost?
It depends on your volume. Let's talk.
Talk to us
Tell us about your claims.
Pricing depends on your volume. Tell us about it.