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Intake to payment, without lifting a finger.

DAY 1· OF 9

Referral arrives by fax

Kaizen classifies the incoming fax and attaches it to the right patient.

ACTIVE
DAY 3· OF 9

Eligibility verified

Kaizen signs into the payer portal and confirms coverage and authorization requirements.

DAY 4· OF 9

Evaluation completed

Kaizen books the evaluation and files the completed note back into the chart.

DAY 6· OF 9

Evaluation reviewed

Kaizen checks the chart against the payer’s medical policy and requests what is missing.

Submit
DAY 7· OF 9

Authorization submitted

Kaizen fills out the payer’s authorization form and uploads the supporting records.

APPROVED
DAY 9· OF 9

Authorization approved

Kaizen posts the approval and authorization number to the chart.

MDVIPGracentBerry StreetBlossomLadder HealthCartwheel
Eligibility verification
Eligibility verification
Kristi Hamilton
Revenue Cycle Director, Gracent
50%
fewer admin hires needed
90%
of eligibility checks automated
$9.6K
monthly revenue recovered
Read case study
Credentialing and enrollment
Credentialing and enrollment
Zeeshan Dawdani
Operations Lead, Berry Street
58%
of enrollment hours automated
1,000+
monthly enrollments processed
34%
of payers automated
Read case study

The clinic of the future, powered by Kaizen.

Referrals worked the hour they arrive, benefits verified before scheduling, authorizations chased to a decision, and providers enrolled with every payer. Four workflows, run end to end.

PATIENT RECORD
01 / 05

Every referral converts, within minutes

Every referral gets instantly processed and immediately scheduled, increasing conversion rates by 100%

Benefits verification
ACTIVE
Plan
PPO Gold
Copay
$40
Deductible
$1,240 met
Coinsurance
20%
Visit limit
24 / yr
Prior auth
Required
02 / 05

Verify every benefit detail before scheduling

Coverage, copay, deductible, visit limits and authorization requirements, all confirmed before the visit.

DAY 1
Authorization submitted
DAY 2
Portal checked, still pending
DAY 3
Called payer, 22 min on hold
DAY 4
Extra records attached on request
DAY 5
Peer-to-peer scheduled
DAY 6
Approved, auth number in the chart
03 / 05

Every follow-up chased until the answer lands

Portal checks every day, calls placed and held through, records sent on request, peer-to-peer booked.

Dr. Amelia Reyes, PT
PAYER ENROLLMENT
Aetna
APPROVED
UnitedHealthcare
APPROVED
BCBS of Texas
IN REVIEW
Cigna
SUBMITTED
04 / 05

Credential every provider

Rosters and payer enrollments stay current, so no payment falls between the cracks.

Claim #22099 · DOS 04/18
CLAIM RESEARCH
Status
Denied
Denial reason
CARC 197 · RARC N54
ERA
Retrieved, filed
Next action
Appeal drafted
05 / 05

Research every stale claim to an outcome

Kaizen finds the claim in the payer portal, reads the denial codes, pulls the remittance, and hands back a claim that is paid, appealed, or scheduled for follow-up.

Working with Kaizen

Live in a week. Better every week after.

Week 1

We connect to the systems you already run.

Your EHR, your payer portals, your fax line and your clearinghouse. Nothing is replaced and nothing is migrated.

athena
Microsoft Dynamics 365
HubSpot
ModMed
salesforce
RingCentral
Week 2

We learn how your team works today.

We interview your team on how the work gets done — every payer quirk, every workaround — so Kaizen runs your process, not a generic one.

SKILLS
3 / 5
Read referral fax
Verify benefits in payer portal
Review chart against policy
Submit authorization
Chase decision
Week 3

Kaizen works with your team like a real employee.

It has its own mailbox. It asks your staff when it needs a call made, answers when they ask where a case stands, and picks a case back up when a payer writes weeks later.

RE: REFERRAL — REYES, A.
Front desk
Mon 9:14
Payer is asking for the PT notes from May. Do we have them?
Kaizen
Mon 9:21
Pulled them from the chart and attached to the auth. Reference #A4-88192.
Aetna
Tue 16:02
Additional records received. Decision pending review.
Kaizen
Fri 15:40
Approved. Auth number posted to the chart — ready to schedule.
Week 4

Track the metrics that matter to you.

Referrals processed, approval rates, hours returned and dollars collected, reported every week.

REFERRALS
1,284
APPROVAL
94%
HOURS BACK
870
CASES COMPLETED / WEEK
+62%
W1W7
Month 2 onward

Roll Kaizen out across your entire back office.

Note audits, claims research, mail processing, records requests, bill generation — each workflow hands over the same way the first one did.

Note audits

Documentation checked against payer policy before it becomes a denial.

Claims research

Stalled claims traced to the reason they stalled, with the appeal assembled.

Mail processing

Inbound mail and remittances sorted, read and filed to the right chart.

Medical records requests

Records chased across offices and portals until the file is complete.

Bill generation

Statements produced and reconciled against what the payer actually paid.

Denials and appeals

Denial reasons read, appeals drafted, and deadlines tracked to submission.

Credentialing

Applications, attestations and roster updates kept current across states.

Patient outreach

Scheduling, reminders and balance follow-up handled without a queue.

Note audits

Documentation checked against payer policy before it becomes a denial.

Claims research

Stalled claims traced to the reason they stalled, with the appeal assembled.

Mail processing

Inbound mail and remittances sorted, read and filed to the right chart.

Medical records requests

Records chased across offices and portals until the file is complete.

Bill generation

Statements produced and reconciled against what the payer actually paid.

Denials and appeals

Denial reasons read, appeals drafted, and deadlines tracked to submission.

Credentialing

Applications, attestations and roster updates kept current across states.

Patient outreach

Scheduling, reminders and balance follow-up handled without a queue.

Continuous improvement, starting today.

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