Service Overview

Springbrook’s Insurance Follow-Up Optimization transforms insurance claim follow-up workflows in Epic into a predictable, scalable process. This engagement improves cash flow, reduces denial risk, and ensures timely filing compliance by combining dynamic claim status automation, workqueue redesign, and thorough knowledge transfer.

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Our AI Agent for this offering is now live:

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What We Deliver

Professional Billing (PB)

• Redesigned follow-up workqueues segmented into No Response, Claim Status, and Payer Rejection.

• CER rules and follow-up profile automations to dynamically time claim status requests.

• Batch jobs to create and deliver ANSI 276 files and ingest ANSI 277 responses.

Hospital Billing (HB)

• Redesigned account workqueues using Springbrook’s framework.

• Batch Workqueues and Batch Workqueue Rules to select and time claims.

• Batch jobs and AIP configuration for outbound/inbound file handling.

Shared Components

• Payer build enabling claim status requests.

• Directories and automations for secure file transfers.

• Weekly live training sessions and comprehensive documentation.

• Optional per-payer rollout for go-live.

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Implementation Process

Discovery & Scoping

• Analyze existing workqueues, payer data, and clearing vendor processes.

• Document routing logic, timing rules, and success criteria.

Configuration & Build

• Create and test all workqueues, automations, and batch processes.

• Configure AIP records and directory structures.

Testing & Validation

• Validate each build component.

• Conduct small-scale production tests on live claims.

Training & Knowledge Transfer

• Weekly live training sessions.

• Complete reference documentation.

Go-Live & Warranty

• Activate automations per payer.

• One-year warranty covering scope deliverables and Epic upgrades.

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Typical Timeline

Phase | Duration

Discovery & Scoping | 2-4 weeks

Configuration & Build | 4-8 weeks

Testing & Validation | 2-4 weeks

Go-Live Support | 4-8 weeks post go-live

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Pricing

Below is our base pricing for this engagement. Actual pricing may vary based on scope, additional service areas, or complexity.

ScopeBase Price (USD)

Professional Billing Only$86,250

Hospital Billing Only$86,250

PB + HB Together$143,750

Additional Service Area (Same Operational Owner)+15% per area

Example:
Two service areas with PB+HB together:
Base Price: $143,750
Additional Area: +15% = +$21,562
Total: $165,312

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Base Pricing Assumptions

• One (1) service area per billing system.

• One operational owner per billing system.

• Dedicated client analyst participates approx. 1-2 hours weekly for knowledge transfer (not build execution).

• Production and recent-clone environments (SUP/TST) provided.

• Springbrook has AIP configuration access, or a client resource performs this work.

• Clearing vendor engagement complete before project start.

• Standard payer configurations (no large-scale custom carve-outs).

• Batch automations scheduled consistently across billing systems.

• Framework reuse of existing configurations whenever maintainable.

• Small-scale production validation per payer before go-live.

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Technical Details at a Glance

• Workqueue build in Epic (account workqueues in HB, follow-up workqueues in PB).

• CER rules (PB) or Batch Workqueue Rules (HB) to determine claim status request timing.

• Batch jobs and AIP records to create and ingest ANSI 276/277 files.

• Secure directories and automations for file transfer to/from the clearing vendor.

• Per-payer rollout and activation available.

Ready to Get Started?

Contact Springbrook Consulting to discuss your organization’s needs and receive a tailored scope and proposal.

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Springbrook Consulting, LLC

Email: info@springbrookconsulting.com

Phone: 260-715-9342
Built on outcomes. Not hours.