Claims Follow-up & Exceptions
Prioritize sample claim exceptions and inspect which cases need human follow-up.
Synthetic data · Stored example outputs · Simulated processing
Explore the workflow
Claim status workflow that converts broad inquiry work into a monitored exception queue. The page shows exception prioritization, selected-claim polling, rules, and labor savings.
- 276/277 EDI status polling with simulated payer latency and failure modes
- Configurable monitoring rules: aged-no-response, partial-payment, denied-pending-followup, missing-status
- Exception queue with SLA breach tracking
- Live labor-cost economics calculator: poll cost vs avoided manual inquiry
- Synthetic claims dataset with realistic CPT codes, payer mix, and status histories