Customer story

Heading Health cut 100+ hours a month of manual claim status.

How an Austin behavioral health practice replaced daily payer-portal checking with Substrate ARC: Claim Status.

100+

hours saved every month

70%

of no-response claims statused hands-free

~20 min

of manual work removed per claim

The challenge

Heading Health's billing team started every day logging into payer portals (Aetna, UHC, BCBS, Cigna, Tricare) to check outstanding claims. Each payer has different portals and logins, and the 276/277 EDI transaction only covers about 500 payers, with inconsistent data. Billers spent up to 15 to 20 minutes per claim on work that should take seconds.

How the Claim Status agent works

01

Tries the highest-probability approach first

Before any request, it checks what worked for similar claims, by payer, client, and state, and starts from accumulated knowledge instead of a blank slate.

02

Interprets failure and adapts

Different errors mean different things. The agent reads the signal and picks its next attempt accordingly, instead of marking the claim failed after one try.

03

Stores every successful pattern

When a combination of NPI, payer ID, and demographics produces a result, it records the pattern. Accuracy compounds as volume grows.

“Substrate eliminated the daily portal-checking for our billing team. The agent follows up on no-response claims automatically and lets my staff focus on denials and collections instead of status hunting.”

Chimene Perez

Director of Operations, Heading Health

See Substrate ARC run your claim status.

Book a 30-minute demo. We'll show you the routing, the success rate, and the worklist write-back on your payers.

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