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The whole revenue cycle, one system of record

Twelve modules share one patient record, one ledger and one audit trail. Below is what each one does today, in the order a claim travels.

Front office

Everything a client practice needs, in one place

Patients, coverage, scheduling and charge entry are the start of every claim. UniPractice keeps them tidy so the claim is right the first time.

Patients

Demographics, documents and a ledger that is always calculated, never stored.

  • Primary, secondary and tertiary coverage
  • Eligibility results recorded per coverage
  • Patient documents and notes

Scheduling

Appointments by provider and location, with status changes and one click to the encounter.

  • Calendar by provider and location
  • Checked in, seen, no-show
  • Create encounter from appointment

Charge entry

Service lines priced from the fee schedule, with diagnosis pointers and modifiers.

  • Fee-schedule pricing
  • Diagnosis pointers and modifiers
  • Saves on Enter

Directory & codes

Providers, referring providers, payers, enrollments, fee schedules and code sets.

  • NPI and taxonomy lookup
  • CPT, HCPCS, ICD-10, POS, modifiers
  • CARC and RARC reason codes

Claims & EDI

Get a clean claim out the door

A rule engine checks every claim before it leaves. Submissions, acknowledgements and rejections are tracked claim by claim, with an audit trail of every change.

Claim scrubber

A rule engine that catches NPI, date, pointer and payer problems before submission.

  • Built-in rules plus your own
  • Errors explained in plain words
  • Fix and rescrub in place

837P submission

Generate 837P batches for the clearinghouse, or produce a CMS-1500 PDF for paper claims.

  • 837P generation and batching
  • 999 and 277CA acknowledgements
  • CMS-1500 (02/12) PDF

11-state lifecycle

Draft to closed, with corrected claims (frequency 7) and voids (frequency 8) built in.

  • Every transition recorded as an event
  • Corrected claims and voids
  • Status at a glance across practices

Rejection work queue

Rejected claims open a work item with the reason, the fix and an appeal letter when needed.

  • One queue across all practices
  • Reason codes decoded
  • Appeal letter generator
  1. Draft From an encounter
  2. Ready Scrub passed
  3. Submitted 837P sent
  4. Accepted 999 + 277CA
  5. Paid 835 posted
  6. Closed Balance resolved
Scrub failed

Rule engine found errors. Fix in place, rescrub.

back to Draft

Rejected

999 or 277CA rejected. Work item opened with the reason.

back to Draft (corrected)

Denied

835 paid $0. Denial queue, appeal letter, corrected claim (frequency 7).

back to Draft or Closed

Partially paid

Secondary claim created automatically, patient balance to statement.

back to Closed

Void

Frequency code 8 sent to the payer. Nothing is deleted.

back to End

Remits, payments & A/R

Get paid and prove it

Electronic remits post themselves. Denials become work items. Aging and collections are always current, so follow-up starts from facts.

835 remittance

Parse 835 files, post payments and adjustments automatically, and hand off to the secondary payer.

  • Auto-posting with double-post protection
  • CARC groups and patient responsibility
  • Manual EOB entry and matching

Payments & ledger

Patient payments applied oldest-first or by hand, refunds, and a ledger per patient.

  • Money in integer cents, no rounding drift
  • Refunds and adjustments
  • Balances calculated from the ledger

A/R & work queues

Aging buckets, a denial queue, follow-up notes and a timely-filing check that flags claims at risk.

  • 0 to 30, 31 to 60, 61 to 90, 90+ day buckets
  • Denial work items with follow-up notes
  • Automatic secondary claims

Statements & reports

Statement runs with dunning levels, plus the reports a billing company reports on.

  • Patient statements as PDF
  • A/R aging, claims by status, collections
  • Provider productivity

Under the hood

Boring where it should be boring

The parts that must be exactly right are built as separate, tested packages. Nothing in the user interface touches raw X12.

X12 engine

837P generator plus 999, 277CA and 835 parsers, written from publicly available payer and clearinghouse companion guides. Raw files are stored and indexed.

Scrubber rule engine

Built-in checks for NPIs, dates, pointers and modifiers. Add your own rules per payer, with plain-language messages.

CMS-1500 renderer

The 02/12 form as a PDF, box by box, for payers that still want paper.

Ledger-first money

Balances are always calculated from the ledger, never stored. Amounts are integer cents, so totals reconcile to the penny.

Background jobs

Submission, acknowledgement polling, remit download and timely-filing checks run as background jobs with retries and a health page.

Clearinghouse adapter

A built-in test clearinghouse for demos, and a Claim.MD connection being tested for production. New connections plug into the same adapter.

Platform console for the SaaS owner: tenants, plans, trials, usage metering and invoices are built in.

See pricing

See UniPractice with your own workflow

A 30-minute walkthrough on demo data: charge entry to claim, submission to remit, denial to appeal. Bring your questions about your hardest payer.

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