The telehealth weight loss status problem
National telehealth brands submit claims in dozens of states but standard electronic status feeds cover only a fraction of payers reliably. Billers manually log into regional Blues, Medicaid MCO, and employer-plan portals until AR queues back up.
Step 1: Inventory payer mix by state
Map which payers accept electronic status, which require portals, and which need alternate identifiers (NPI type, member ID format).
Step 2: Deploy multi-path status automation
Use feeds first with intelligent retry, then portal automation, then direct connections. Single-path tools leave gaps that manual teams cannot scale.
Step 3: Normalize results to your PM
Return specific denial reasons, not generic "see remittance" codes. Route medical necessity and records denials to appeals automatically.
Step 4: Monitor no-response queues
Claims with no payer response are the highest-ROI automation target for weight loss programs with thin margins per visit.
Clearinghouse vs full payer coverage
Keep your clearinghouse for submission. Add handsfree automation for status and follow-up on payers standard feeds miss. Substrate works alongside Waystar, Stedi, Availity, and others.