The pilot practice: a coaching and nutrition practice, year one on auro

About the practice

A coaching and nutrition practice with one provider, seeing patients on insurance and self-pay, in office and on Zoom. Before auro, eligibility was a phone call on hold, notes were written after hours, and claims went out when there was time.

Week one: the calls

Lana took the eligibility line. Each day’s appointments were verified the night before: the payer’s provider line dialed, the member ID read back digit by digit, the reference number filed with the recording and the transcript. The average call ran 41 seconds. The calls a rep could not answer were flagged for review, not guessed.

Weeks two to four: the notes

Every visit was recorded with the patient’s consent and drafted as a note in the practice’s own template, with the PES statement and the care plan pulled from the conversation and the logs. The provider read and signed. Twelve of twelve notes for billed visits were signed by the close.

Month two: the claims

The signed note became the claim, coded from the visit and checked against the payer’s rules before it left. Claims went out the night of the visit and were tracked to the remittance; the short-pays were held with the reason and the call that had verified the benefit. In the pilot, 98% were paid on first pass.

• Verification: a 41 second average call, with the recording and the reference number on the record.
• Notes: twelve of twelve signed for billed visits.
• Claims: 98% paid on first pass.
• Patients: 84% logging every day from the app.

The close

September’s close was thirty-seven checks: charges posted for every visit, batches reconciled, remittances posted, notes signed for billed visits. The owner reviewed and locked it in an afternoon.

What is next

Year two adds the supply shelf and group programs to the same record. Every number above is on the ledger; the testimonial will come from the practice in its own words, verified, never invented.