Billing Phase
Closing the financial loop. Reconciling the win with the original hospital ledger.
Phase 5 Overview | The Strategy Behind Settlement Posting
Winning a case is only half the battle. Phase 5 is where you ensure that every dollar recovered is accurately posted to the correct claim line-items and reconciled with the hospital's revenue cycle system.
Line-Item Settlement Posting
The platform matches settlement payments to specific claim line-items, ensuring that each recovered dollar is attributed to the correct service and revenue account.
Automated Fee Calculation
Legal fees, contingency percentages, and expense reimbursements are calculated automatically based on the settlement agreement, with full transparency for all parties.
Revenue Cycle Reconciliation
The platform syncs with your hospital's billing system to ensure that recovered payments are posted correctly and reflected in financial reports.
Actionable Worklists | The "How" of Phase 5
Phase 5 is where financial accuracy meets operational discipline. Here's how your billing team will operate inside the platform.
Payment Posting Queue – Matching Insurance Wires/Checks to Specific Claim Line-Items
When a payer sends a settlement payment, the platform matches the payment to the correct claim line-items and posts the recovery to the hospital's accounts receivable system.
Trigger Action:
If the payment amount does not match the expected settlement, the platform flags the discrepancy and routes it to the billing manager for review.
Fee Distribution Worklist – Calculating and Distributing Legal Fees
The platform calculates legal fees, contingency percentages, and expense reimbursements based on the settlement agreement, generating invoices for all parties.
Trigger Action:
Once fees are approved, the platform generates payment instructions for the hospital's finance team and tracks the distribution of funds to external counsel.
Reconciliation Queue – Ensuring Financial Accuracy Across Systems
The platform compares the recovered amounts against the original claim values, identifying any discrepancies and ensuring that all financial records are accurate.
Trigger Action:
If a reconciliation error is detected, the platform alerts the billing manager and generates a detailed audit report for review.
Integrated Technology | How Phase 5 Is Powered
EMR Connect Financial Sync
The platform integrates with your hospital's EMR and billing system to post settlement payments automatically, eliminating manual data entry and reducing posting errors.
Supported integrations include Epic, Cerner, Meditech, and Allscripts, with custom API connections available for proprietary systems.
Automated Contractual Write-Off Engine
The platform applies contractual adjustments automatically based on the settlement agreement, ensuring that all write-offs are properly documented and auditable.
This eliminates the need for manual adjustments and ensures that your financial statements accurately reflect the final recovery amounts.
The Transition | Moving from Phase 5 to Phase 6
A case only advances to Phase 6 (Case Closure & Archiving) when the platform confirms that all settlement payments have been posted, all legal fees have been distributed, and all financial reconciliations are complete.
Automatic Trigger |
Once all financial tasks are complete, the platform automatically moves the case to Phase 6 and begins the compliance audit and archiving process.