Workflow
Every status a claim can be in, and how it gets there.
Claims move through clear states. Lists are honest because status changes come from real actions, not someone remembering to update a cell. Walk the diagram below to see who acts at each step — a person, MEDBIX, an AI agent, the clearinghouse, or money moving — and where a named decision is required.
Diagram
The steps
Each step shows who acts: a person, MEDBIX, an AI agent, the clearinghouse, or money moving.
- Person decides
- MEDBIX
- Clearinghouse / payer
- 1
Draft
Person decidesBeing built or corrected.
- 2
Validating / ready
MEDBIXScrub rules have run.
- 3
Pending review
Person decidesWaiting for an approver.
- 4
Approved
Person decidesSigned off by a person.
- 5
Queued
MEDBIXLined up for the clearinghouse.
- 6
Submitted
Clearinghouse / payerSent as an 837.
- 7
Accepted / rejected / correction / failed
Clearinghouse / payerThe response decides what's next.
Back to draft with a reason
Correction required → draft
Correction required → draft
The principles behind it
No silent jumps
A claim can't skip review on its way to submitted.
History survives
Corrections reopen to draft without erasing what happened.
Statuses mean something
Each state matches a real step in the process.
Ownership
Who does what
| Who | What they do in this workflow |
|---|---|
| Biller | Moves claims from draft to pending review. |
| Supervisor | Approves or returns. |
| System | Validates, queues, submits, records responses. |
Features in this workflow
On the floor
What this looks like in practice
These cues come from the same workflow — useful when you are mapping MEDBIX to how your team already works.
human
Draft
Being built or corrected.
system
Validating / ready
Scrub rules have run.
human
Pending review
Waiting for an approver.
Next
Walk it live, or open a related feature
A demo follows this path with synthetic data. Feature pages spell out capabilities, roles and guardrails for each piece.
Other workflows
The full RCM loop
From insurance on file to money in the bank, in one loop.
The human approval gate
AI can suggest. Only your team can send.
Denial workflow
From denial to resubmission, with a person at the wheel.
Patient payment workflow
From balance to paid, in the fewest taps possible.
Tenancy model
Billing company on top. Practices underneath. Walls in between.
Deep dive
What Claim Lifecycle means in daily ops.
Practical context for Claim Lifecycle: how teams use it, where it sits in the loop, and what to ask in a demo.
- Tied to how billing work actually splits
- Clear on human vs machine responsibility
- Links into related MEDBIX areas
Practice
Where this shows up on a busy day.
From morning eligibility checks to end-of-day posting, Claim Lifecycle connects to the queues your team already lives in.
- Morning coverage and claim build
- Midday scrub and approval
- Afternoon denials and patient pay
Control
Keep a person on the send button.
Whatever page you're on, MEDBIX keeps AI in a propose role. Approvals, posting and rule activation stay human.
- Named approvals
- Visible AI proposals
- Immutable audit trail
Next
Walk Claim Lifecycle live
Bring your payer mix and the friction you feel today. We'll map it onto sample data in thirty minutes.
- Sample data only
- Your questions drive the agenda
- Written follow-up after
Common questions
What does 'failed' mean?
Something went wrong technically on submission, as opposed to a payer rejection.
Can we correct an accepted claim?
Yes, through the correction path.
Want to walk MEDBIX against your real claim mix?
Thirty minutes with sample data. We'll follow one claim through the gate, then talk about your payers, practices and where the rework hurts today.
Notes from the billing floor
Occasional, practical writing on denials, A/R and running a billing company. No spam, unsubscribe any time.