From census to payment, with a receipt at every step
Mailed claims leave the building and go silent until a remittance arrives weeks later. Electronic claims come back with confirmations within hours, and a problem is fixed the same day instead of discovered at month end. Here is the cycle we run every week, and how a facility moves onto it.
Five stages, each with its own check
Census and eligibility
Roster, tiers, approved hours, and move dates reconciled. Each resident's Medi-Cal eligibility is confirmed electronically before anything is billed.
Claims built and checked
Each resident's claim is generated from the census and run through our validation checks. Anything that would be denied is fixed before it leaves.
Sent to Medi-Cal
The batch is transmitted electronically under your facility's own provider number. Every batch gets a tracking number.
Confirmations
Medi-Cal confirms receipt, format, and acceptance of each claim. Any rejection is corrected and resent in the same cycle.
Payment reconciled
The remittance is matched line by line to the batch. Paid, short-paid, and denied lines are classified and the next week's follow-ups are queued.
Silence is where money disappears
With mailed claims, the first sign that something went wrong is a denial on a remittance, often three to five weeks after the service month. By then the fix is competing with the current week's billing, and some corrections are drifting toward Medi-Cal's six-month deadline.
Electronic submission replaces that silence with a confirmation at each stage. When a claim stalls, we know exactly where, and the facility sees it on the weekly report instead of finding out at year end.
- Receipt confirmed within minutes of sending
- Format and acceptance confirmed the same day
- Rejections corrected before the remittance cycle, not after
- Every batch traceable by its tracking number
Moving from paper without risking a payment cycle
No facility goes dark while we switch. Paper continues until the electronic path has paid real claims.
Enrollment and testing
We handle the electronic submitter enrollment with Medi-Cal and run a test batch built from claims that have already paid, correcting anything flagged until it passes clean.
Pilot
A small live batch, a few residents for a few days of service, including both ALW-only and ALW-plus-RH claims. The rest of the census stays on your current process.
Parallel run
Pilot payments are reconciled and compared against paper. Once electronic claims have paid at the expected rate, the next cycle moves half the census, then all of it.
Standing operations
Weekly electronic runs, confirmation tracking, remittance review, and a report to ownership every Monday.
Same claim, delivered with a receipt
| Question | Mailed claims | Electronic claims |
|---|---|---|
| Did the claim arrive? | Unknown until a remittance line appears | Confirmed within minutes |
| Was there an error? | Denied on the remittance weeks later | Flagged within hours, corrected the same day |
| How long until payment? | Mail time, scanning, then the payment cycle | The payment cycle only |
| What does a correction cost? | Reprint, repackage, remail | Fix the line, resend |
| How do you see status? | A stack of printed remittances | A weekly report by resident and program |
| What stays the same? | The claim itself. Codes, tiers, units, and your facility's provider number are identical. | |
Still mailing claims? Let us run the first batch.
The free review includes a readiness check: enrollment status, submitter setup, and what your first test batch would contain.