Revenue cycleLive · in the productQueue & boardHand-crafted

ClaimsLine

Get paid by insurers on the first try.

Shown in the product as “Insurance Claims”

Get ClaimsLine Open the appAvailable nowHow pricing works →

What it is

The claim as a journey: cashless starts at pre-auth, reimbursement at submission, and every state change appends a visible event with who, when and how much. Approvals and settlements demand amounts; denials, rejections and withdrawals demand reasons — the ledger that improves the next claim. Beside the pre-auth packet, Claims exchange prepares the claim as a FHIR bundle for the National Health Claims Exchange and keeps every attempt on a log; until the hospital is enrolled on the exchange it refuses to send, and says so on the claim. Cases: every open insured claim as one case — the pre-auth, each query the TPA sends, the enhancements as the bill grows and the discharge approval, read from Cashless clocks — with who it waits on and the next step, so a case manager with forty files sees which is stuck and why. Each insurer is scored from the clinic’s own claims: pre-auth time, rejection rate, time to pay and how much short. The paperwork an insurer asks for (mental-health sessions are the usual case) is written down once with where it came from, put on a claim and ticked item by item. The patient’s Insurance screen shows the same claim in plain words, including a question from the insurer, with the story so far.

Who uses it: Billing, TPA deskBuilt for: Hospitals
Reads: Signed notes, bills, policy
Writes: Claims
Never: Sends a claim without a person’s check
Access: Only people whose role includes it — the clinic owner decides who
Your data: Full PHI. Hosted in Boston, United States. On uninstall: Claim history stays with the bills.

In the product

Who uses it: Insurance desk — the demo profile it is best tried as
Where it opens: Revenue cycle › Claims /claims
Permission: claim.read

Every revenue cycle app in the handbook →

How it works

Open the claimPatient, payer or TPA, policy number and the estimate. Cashless starts at pre-authorisation; reimbursement starts at submission.
Move it a stage at a timeEach change appends an event with who, when and how much. A settlement without a submission is not a thing the model can represent.
Amounts and reasons are demandedAn approval or a settlement will not go through without its amount; a denial, rejection or withdrawal will not go through without its reason.
Work the oldest-touched firstEvery stage of the pipeline sorts that way, which is how a claim stops ageing quietly at the bottom of somebody’s list.
Work the casesOn Cases, each insured patient is one case, with the TPA’s query, enhancement or discharge request read from Cashless clocks, who it waits on and the next step. Below it, each insurer’s pre-auth time, rejections, time to pay and short payment over the year. Write down the paperwork an insurer asks for, with where it came from, put the list on a claim and tick each item ready; the patient sees the same story in plain words.
AI helpsExplains a rejection and drafts the appeal and the pre-auth justification. You stay in charge.

Rules it keeps

What it does not do, by design. A listing with only benefits is an advertisement.

It does not draft clinical justifications the chart cannot back, and it cannot skip a step — a settlement without a submission, or a denial without a reason, is unrepresentable.

Nor does it mark a claim sent to the exchange that the exchange has not accepted.

It does not decide what an insurer covers or which code it accepts: a paperwork list holds what the insurer told you, with the source, and the insurer still decides.

AI in ClaimsLine

AskQuestions about what is on screen — “What needs attention in ClaimsLine today?” — answered with the records it read.

DraftSummaries and notes for the team, marked as drafts until a person signs.

In this appExplains a rejection and drafts the appeal and the pre-auth justification.

Not AINo diagnosis codes are suggested and no denial is predicted.

Every answer shows its sources. Nothing AI writes is saved until a person accepts it.

Its screen

QueueClaims · September

From the design, with its example clinic.

Try it

The design preview: every screen drawn with the product’s own blocks, on an example clinic’s demo data. Nothing here is a real patient.

Open full screen →

Design preview · Insurance Claims · example clinic

Open the interactive design preview →

Connected to

Read out of the code, not the brochure: each app below is here because one service queries the other’s tables. Install either side and the hand-over is already wired.

Reads from · 10

AdmitLine BillDesk CaseNotes CashlessSLA ClaimScrub LabBridge Patient Registry PriceQuote RxCanvas WardLine

Hands to · 13

AdmitLine Automations BillCheck BillDesk CashlessSLA CGHSDesk ClaimScrub DenialWorks ImageVault LedgerBooks MRDTracker PMJAYDesk RevenueLens

See the whole clinic →

Questions clinics ask

What does ClaimsLine do?

Insurance pre-auth and claims, tracked like a journey — every insured patient as one case, and each insurer on its record. The claim as a journey: cashless starts at pre-auth, reimbursement at submission, and every state change appends a visible event with who, when and how much. Approvals and settlements demand amounts; denials, rejections and withdrawals demand reasons — the ledger that improves the next claim. Beside the pre-auth packet, Claims exchange prepares the claim as a FHIR bundle for the National Health Claims Exchange and keeps every attempt on a log; until the hospital is enrolled on the exchange it refuses to send, and says so on the claim. Cases: every open insured claim as one case — the pre-auth, each query the TPA sends, the enhancements as the bill grows and the discharge approval, read from Cashless clocks — with who it waits on and the next step, so a case manager with forty files sees which is stuck and why. Each insurer is scored from the clinic’s own claims: pre-auth time, rejection rate, time to pay and how much short. The paperwork an insurer asks for (mental-health sessions are the usual case) is written down once with where it came from, put on a claim and ticked item by item. The patient’s Insurance screen shows the same claim in plain words, including a question from the insurer, with the story so far.

What data does ClaimsLine read and write?

ClaimsLine reads bills, the chart, cashless requests and writes claims, authorisations, insurer paperwork lists. Its data class is Full PHI. Every app works on the same patient record — nothing is copied into a silo.

What does ClaimsLine deliberately not do?

It does not draft clinical justifications the chart cannot back, and it cannot skip a step — a settlement without a submission, or a denial without a reason, is unrepresentable. Nor does it mark a claim sent to the exchange that the exchange has not accepted. It does not decide what an insurer covers or which code it accepts: a paperwork list holds what the insurer told you, with the source, and the insurer still decides.

What happens to our data if we uninstall ClaimsLine?

Claim history stays with the bills.

Is ClaimsLine available today?

Yes — ClaimsLine is live in clinics today. Set up your practice on MedAppz and install it from your dashboard.

Want to see ClaimsLine running on your own patients?

Tell us what you run and we will show you this app inside a practice shaped like yours — or answer the question the page above did not.

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