↗Scheduled
Check returned benefits before the visit
Scheduled insurance verification and PMS updates.
Review missing or unclear returned benefits before estimating patient costs.
Confirm payer/PMS action scope for your setup.
View workflow details +
- Starts when
- Patient scheduling triggers configured verification · Appointment in a supported connected PMS, patient and payer details
- Xpand does
- Checks supported insurance sources and updates enabled benefit fields, PDF and note outcomes.
- Output
- Returned benefits, enabled PMS fields, PDF and provider note
- Staff reviews
- Missing or unclear benefit details and separate failed outcomes.
Steps and setup scope
- A scheduled patient starts the configured workflow
- Xpand checks supported insurance sources and organizes returned benefits
- Enabled PMS benefit fields, breakdown-of-benefits PDF and short provider note are updated
- Missing or unclear details go to the appropriate reviewer; separate failed outcomes can be retried
- Optional user-started route: upload the Auto Verify queue and start Verify All
Sample output · Insurance verification
- Benefits
- Returned fields organized
- PMS fields
- Updated when enabled
- PDF / note
- Separate supported outcomes recorded
- Exception
- Missing frequency limit flagged for follow-up
Illustrative outcome record. Payer support, enrollment, identifiers and PMS/version action scope apply. Completed required actions are skipped; missing benefits need follow-up before estimates.
See benefits verification↗
↗Scheduled
Remittances without repeated downloading
Automatic ERA/EOB retrieval, matching and supported payment posting.
Review the match and posting results instead of repeatedly downloading the same remittance files.
Confirm payer/PMS action scope for your setup.
View workflow details +
- Starts when
- Configured retrieval when remittance files are available · Available ERA/EOB from a configured connected insurance source
- Xpand does
- Retrieves available remittances, matches patient/claim and runs enabled payment, PDF and note actions. Confirm any required review or approval steps for the configured workflow.
- Output
- Matched patient/claim and separate enabled payment, PDF and note outcomes
- Staff reviews
- Unclear matches and each failed or incomplete write outcome.
Steps and setup scope
- Retrieve available ERA/EOB files from configured connected sources; optional single-file or bulk upload is also supported
- Match the remittance to the patient and claim and cross-check the details
- Complete enabled PMS payment, PDF attachment and note actions, skipping required actions already updated; confirm payment, PDF and note outcomes separately before retrying failed actions
- Flag unclear or unmatched records for the appropriate reviewer; retry failed outcomes separately
Sample output · Automatic ERA/EOB retrieval, matching and supported payment posting.
- Match
- Patient and claim identified
- Payment
- Enabled write outcome recorded
- PDF / note
- Separate outcome statuses recorded
- Exception
- Unclear match flagged; failed action retained for retry
Illustrative outcome record, not a customer result. Availability, enrollment and enabled payment/PDF/note actions vary by source, PMS version and practice setup. A retrieved document does not prove every write succeeded. Standard plans include unlimited supported payment posting with no extra posting fee; Custom terms are by agreement. View payment posting and plan details →
Explore payment posting↗
↗Scheduled
Secondary claim details kept together
Automatic secondary claims with the primary response in context.
Carry the primary response into automatic secondary claim submission.
Confirm payer/PMS action scope for your setup.
View workflow details +
- Starts when
- Configured automatic secondary submission · Primary insurance response and the patient/claim details needed for secondary coverage
- Xpand does
- Submits the secondary claim automatically through the configured supported route.
- Output
- Secondary submission outcome and unresolved items for follow-up
- Staff reviews
- Missing details, payer errors and the secondary submission outcome. No primary submission.
Steps and setup scope
- Use the primary response and matching claim context
- Prepare the supported secondary claim with required details
- Xpand submits the secondary claim automatically through the configured supported route
- Keep missing details or returned errors with the claim for follow-up
Sample output · Automatic secondary claims with the primary response in context.
- Primary response
- Linked to the claim context
- Scope
- Automatic secondary submission only
- Submission
- Outcome retained for follow-up
- Exception
- Missing data or returned error needs attention
Illustrative workflow. Xpand submits secondary claims automatically; it does not submit primary claims. Payer requirements, enrollment, connection and enabled action scope apply. Confirm the enabled production route, required enrollment and returned submission outcome for your setup.
Explore secondary claim workflow↗
↗User-started
Stop rediscovering the same claim
Claim-status checks with the next action in view.
Help billers spend their attention on unresolved balances.
Confirm payer/PMS action scope for your setup.
View workflow details +
- Starts when
- Start batch claim checks · Claims worklist with patient, payer and service date
- Xpand does
- Collects supported claim-status responses and prepares follow-up results.
- Output
- Returned statuses and an exportable follow-up report
- Staff reviews
- Payer messages, denied or unresolved balances and the assigned next action.
Steps and setup scope
- Import the claim worklist
- Collect supported payer responses
- Prioritize exceptions and export results
Sample output · Auto AR claim checks
- Paid
- Response available · review payment details
- Denied
- Payer reason returned · assign next action
- Pending
- Keep next check visible
- Official ERA / EOB
- Separate remittance connection and matching file required
A status PDF organizes the response; it is not an official carrier EOB.
Explore claim follow-up↗
↗Assisted
Less benefit-form retyping
Structured benefits forms with the source in view.
Reduce repeated copying while keeping the source in view.
Confirm payer/PMS action scope for your setup.
View workflow details +
- Starts when
- Prepare the benefit form · Supplied or returned benefit information
- Xpand does
- Organizes supplied or returned benefit information into structured fields.
- Output
- Structured coverage, deductible and maximum fields
- Staff reviews
- Source accuracy and missing details before using the form.
Steps and setup scope
- Add the benefit source
- Prepare structured fields
- Check details before using the form
Sample output · VOB Auto-Fill
- Eligibility
- Recorded from source
- Deductible
- Source amount retained
- Annual maximum
- Source amount retained
- Unreturned details
- Left for follow-up
Form preparation organizes supplied information; it does not create a new payer response.
See benefit form workflow↗