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Solutions

Healthcare workflow automation for the seven bottlenecks in every practice.

Whatever your specialty, the operation breaks in the same places: authorizations, phones, faxes, denials, no-shows, eligibility, and the revenue cycle that ties them together. Each has a dedicated Simz playbook, and they all run on one platform, one BAA, and one HIPAA framework, so you can start with the one that hurts most and expand from there.

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No obligation. Response within one business day.
One platformevery solution on the same BAA & HIPAA framework
6-8 wksfrom kickoff to your first live automation
24/7automations that never sleep or call out
Human-in-loopstaff review for every uncertain AI decision
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THE SEVEN BOTTLENECKS

Pick the one that hurts most. Start there.

Every engagement begins with a free workflow audit that quantifies each bottleneck in your practice, so the first automation you build is the one with the fastest payback.

SOLUTION 01 · PRIOR AUTHORIZATION

Prior authorization

Requirements determined by payer, plan & CPT the moment an order arrives; packets assembled from the record; status tracked to approval; every expiration watched, with your staff approving every submission.

Order arrives→
Auth required?→
Tracked to approval→
Expiration watched
  • Payer/plan/CPT rules engine, instant, consistent determination
  • Auto-assembled packets, complete the first time
  • Countdown alerts before any auth lapses
Kill this bottleneck →
SOLUTION 02 · PHONE & DESK COVERAGE

Inbound phone & desk coverage

Every call answered 24/7, nights, weekends, lunch rush, and overflow, with intake collected, coverage verified in-call, and appointments booked or warm-transferred. Clinical calls escalate to staff instantly.

Phone rings→
Answered instantly→
Verified in-call→
Booked
  • Unlimited concurrent calls, nobody waits, nobody hangs up
  • In-call 270/271 eligibility verification
  • 100% of calls recorded, transcribed & QC-scored
Kill this bottleneck →
SOLUTION 03 · FAX & REFERRAL INTAKE

Document, fax & referral intake

Fax queues and shared folders monitored around the clock: every field extracted with confidence scoring, documents named and filed to your conventions, duplicates caught, and anything uncertain verified by a human.

Fax lands→
AI reads & extracts→
Named & filed→
Routed
  • Field-level extraction, benchmarked on your documents
  • Duplicate & revision detection built in
  • Accuracy locked as contractual acceptance criteria
Kill this bottleneck →
SOLUTION 04 · DENIALS & APPEALS

Denials & appeals

Every denial captured with its payer reason, triaged by value and winnability, and turned into a draft appeal packet for biller review, with deadlines tracked and root causes fixed upstream so the same denial stops recurring.

Claim denied→
Appeal assembled→
Deadline tracked→
Root cause fixed
  • Draft appeal packets in minutes, not an hour each
  • Zero appeal deadlines missed to the calendar
  • Root-cause analysis by payer, CPT & reason
Kill this bottleneck →
SOLUTION 05 · NO-SHOWS & RECALL

No-shows, recall & reactivation

Confirmation sequences that cut no-shows, same-day waitlist backfill when someone cancels, recall lists worked every day until booked, and reactivation campaigns for patients who quietly disappeared.

Due list built→
Outreach runs→
Booked & confirmed→
Chair filled
  • Multi-channel sequences, text, AI voice, email
  • Same-day backfill from the waitlist, automatically
  • Recall & reactivation worked daily, every attempt logged
Kill this bottleneck →
SOLUTION 06 · ELIGIBILITY & BENEFITS

Eligibility & benefits verification

Real-time 270/271 on every scheduled visit day ahead, full benefit breakdowns filed to the record, coverage re-checked on changes, and staff worklists reserved for actual problems.

Visit on schedule→
270 sent→
Benefits filed→
Flags to staff
  • Full breakdowns: limits, frequencies, waiting periods, maximums
  • Automatic re-verification before every visit
  • The engine that powers auth, estimates & denial prevention
Kill this bottleneck →
SOLUTION 07 · Revenue Cycle Management

Revenue cycle management

The follow-up layer over your whole cycle: clean front-end verification, automated claim status tracking, denial workflows, prioritized AR worklists, and patient balance outreach, working alongside your billing team, never replacing it.

Clean claim out→
Status tracked→
Denials worked→
Paid & posted
  • Claim statuses checked on cadence, with silence gets flagged
  • AR worklists ranked by value, payer & deadline risk
  • Patient balances followed through with payment links
Kill this bottleneck →

The bottlenecks feed each other. So do the fixes.

A referral that's extracted cleanly gets verified correctly. Verified benefits drive accurate auth determination. Verified, authorized patients get scheduled, and confirmed patients show up. Clean claims come out the other end, and the few denials that remain trace back to a fixable cause. Automate one stage and it helps; automate the chain and the whole operation compounds.

Intake→
Eligibility→
Prior auth→
Scheduled & confirmed→
Clean claim→
Paid
Fewer denials start with better intake and verification, not better appeals.
Fuller schedules come from answered phones, worked recall lists, and backfilled cancellations.
Faster payment comes from auths that never lapse and claims that go out clean.

By specialty

See these solutions in your specialty

Every solution adapts to your specialty's payers, systems, and workflows. Explore the dedicated playbooks:

Radiology & imaging→

Order intake, auth tracking, referrer analytics

PT & rehab→

Visit limits, recerts, plan-of-care completion

Oncology & infusion→

Per-regimen auth, chronologies, chair time

Dialysis & nephrology→

Chairs, shifts, missed-treatment recovery

Dental & DSOs→

New-patient calls, recall engine, tx follow-up

Surgery centers→

Pre-op readiness, block utilization, post-op calls

Why we're confident

This engine is already running in production

The platform behind these solutions is live today with a multi-site radiology group in Southern California, a phased engagement covering AI intake, real-time eligibility, authorization tracking, a 24/7 phone agent, and analytics, on one MSA, one BAA, one HIPAA framework.

Powered by Simz Conversational, Simz Shift, and Simz Chron, with custom development for everything else.

  • BAA executed before any PHI moves
  • HIPAA-eligible infrastructure end to end
  • Human review on every uncertain AI decision
  • Role-based access with full audit logging
  • Accuracy benchmarked on your documents, and locked as acceptance criteria

Not sure which bottleneck to kill first?

That's exactly what the free workflow audit answers. Thirty minutes with your operations lead: we map all seven bottlenecks in your practice, quantify what each one costs, and hand you a roadmap ranked by payback, whether or not you build it with us.

Book your auditBook your auditNo pitch deck. No obligation. Just a map of your busywork.