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3

Claim Automatic Attachments 

Overview

Springbrook Consulting and FIT Solutions provide a turnkey implementation of automated claim attachments in Epic Resolute. This engagement combines both proactive attachments (submitted with initial claims) and reactive attachments (generated and submitted in response to payer requests). The solution ensures every claim is supported by the appropriate documentation, reducing denials and accelerating reimbursement.

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This service is developed in partnership with FIT Solutions (fitsolutions.biz)

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Scope of Work

Included Activities:

  • Discovery and analysis of payer requirements, claim types, and documentation sources

  • Configuration of Claim Edit Rules (CER) and Electronic Attachment Framework (EAF) records

  • Integration of ROI Release of Information templates

  • Build and validation of proactive attachment workflows

  • Build and validation of reactive attachment workflows

  • Testing of initial and post-submission attachment scenarios

  • Training and knowledge transfer for client analysts

  • Post-live monitoring and validation of claim acceptance and payment

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Technical Details

  • Proactive Attachments: Automatically generated when claims are created (for example, Worker’s Compensation).

  • Reactive Attachments: Triggered by payer rejection codes or correspondence after claim submission.

  • Supported File Types: ANSI 837I/837P plus PDF attachments.

  • Workqueue Integration: Dedicated queues for attachment validation.

  • Transmission: Client-managed SFTP to clearing vendor.

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Typical Project Timeline

PhaseDuration

Discovery & Design3–4 weeks

Build & Configuration4–6 weeks

Testing & Validation2–3 weeks

Go-Live & Monitoring2–4 weeks active

Post-Live Payment ValidationUp to 8 weeks (includes downtime while claims are adjudicated)

Total Estimated Timeline: Approximately 3–4 months depending on client readiness and payer timelines.

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Pricing Table

DescriptionFixed Fee

Proactive + Reactive Attachments Combined$60,000

Additional Service Areas Under Same Sponsor+20% per area

Optional File Transfer Script Development scoped separately

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Base Pricing Assumptions

Pricing is based on the following conditions:

  • Client has Epic modules and licensing to support claim attachments.

  • A client EDI or IT resource is responsible for:

    • SFTP folder creation at the clearing vendor.

    • Development and maintenance of file transfer scripts.

  • Client will staff an analyst for knowledge transfer and validation (approximately 1–2 hours per week).

  • Payer requirements and attachment samples are provided at project start.

  • File transfer automation is not included in base scope but can be added by separate agreement.

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Post-Live Support and Warranty

Springbrook Consulting will:

  • Monitor claim acceptance and attachment processing during go-live.

  • Provide escalation support during the in-flight processing phase while claims await adjudication.

  • Validate payment outcomes once remittances are received.

  • Offer a one-year warranty on original configuration, including remediation of defects and updates required due to Epic upgrades.

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Summary of Benefits

  • One project delivering both proactive and reactive automation

  • Faster, more complete claim submissions

  • Reduced manual work and rejections

  • Clear, fixed-fee pricing

  • Thorough documentation and training

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Contact

Springbrook Consulting, LLC

Email: info@springbrookconsulting.com / fitsolutions.biz

Phone: 260-715-9342

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