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Doctor Billing

Doctor Billing

Clinics

The clinic gets paid for what it treated.

Doctor Billing is claims management for clinics: eligibility before the appointment, approval before the treatment, the claim built from the encounter itself, and denials corrected rather than absorbed. It runs on the same payer connections as 2,000+ HSA sites — Shafafiya, DHPO and NPHIES — with EzDx, or alongside the EMR you already have.

1M+

claims processed on HSA gateways

3

payer gateways live

1 day

to onboard*

* Hardware and network ready on the day. Connecting your payer mailbox is scoped separately.

Product screenshot

Approved and connected

The gateways your clinic claims through.

See every certification →

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Shafafiya

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DHPO

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NPHIES

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Malaffi

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NABIDH

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Riayati

What it does

Everything between the appointment and the payment.

A clinic's revenue leaks in two places: treatment given without checking cover, and claims denied without anyone going back for them. Doctor Billing closes both, inside the consultation workflow rather than in a billing office down the corridor.

Eligibility before treatment

The patient's cover, plan and TPA are checked at reception, so nobody is treated on an assumption and nobody is billed for a surprise.

Prior approval

Approval requests for procedures that need them, submitted and answered before the treatment rather than argued about after it.

Claims built from the encounter

The diagnosis and procedures recorded by the doctor in EzDx become the claim, so nothing is re-keyed from a paper note. Clinics keeping their existing EMR can import claims as an Excel file instead.

Submission to every gateway you're licensed on

Online and offline claims to Shafafiya, DHPO or NPHIES, depending on where the clinic is licensed.

Remittance and reconciliation

Remittances downloaded and matched against submissions, so short-payment and non-payment show as two different problems.

Denial correction

Denials arrive with their reason, are corrected and resubmitted from the same screen, and are grouped so you can see whether the pattern is one payer, one procedure or one doctor's documentation.

Operator on the floor

A day in the clinic

How the claim actually goes.

STEP 01

Reception checks cover

The patient's insurer, plan and TPA are verified before they sit down. What is covered, and what the patient pays, is known at that point rather than at the desk on the way out.

STEP 02

Approval comes back

Anything needing prior authorisation is requested and answered before treatment. The doctor is told what is approved, not asked to guess.

STEP 03

The encounter becomes the claim

The doctor records the diagnosis and procedures. That record is the claim — coded once, by the person who did the work.

STEP 04

The money is matched, or chased

Remittances reconcile against submissions. Denials come back with a reason, get corrected and go out again, and the pattern report shows where the rejections keep starting.

Inside the product

Modules, in the order you'd meet them.

Three screens between the appointment and the bank. Each removes a way for a clinic to work for free.

Eligibility and approvals

Where the loss is prevented: cover verification at reception, prior authorisation requests, and the insurer, plan and TPA records behind them. A clinic that checks cover first does not write off treatment later.

Eligibility Prior approval

Module screenshot

Claim capture

Where accuracy comes from: the claim is assembled from the doctor's own diagnosis and procedure record, not transcribed from it. Coding is done once, at the point the clinical decision was made — or imported from your existing EMR as an Excel file.

From the encounter Excel import

Module screenshot

Reconciliation and denials

Where the money is recovered: remittance download, claim status, denial reasons, correction and resubmission, with rejection patterns grouped by payer, procedure and doctor.

Remittances Resubmission

Module screenshot

Proof

One customer, one number, one quote.

[Customer quote to come — two sentences from a named operator at a named site.]

[Name Surname]

[Role · Organisation]

[00%]

Outcome measured

[00m]

Outcome measured

Deployment

One day alongside EzDx — we register your insurers, plans and TPAs, configure the approval rules, and run the first submissions with your team watching. Connecting your Shafafiya, DHPO or NPHIES mailbox depends on the authority's own onboarding, which we handle but do not control the clock on.

Works with

Pairs with the rest of the suite.

Each of these does its own job. Most customers add the next one once the first has paid for itself.

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EzDx

The clinical record Doctor Billing builds every claim from — the claim is only this accurate when it comes straight from the encounter.

EzRx

The same claims job on the pharmacy side. Clinics with a dispensing pharmacy on site run both.

CCMS

For clinic groups that centralise claims into a back-office billing department.

AMS

Insurer receipts arrive as identified receipts against receivables rather than unexplained bank lines.

Questions

The four things clinics ask first.

What it is, what it needs, who codes, and what happens to a rejection.

Is this the same thing as EzRx?

It is the same job — eligibility, approval, submission, remittance, denials — for a clinic rather than a pharmacy counter. The difference is what the claim is built from: a clinical encounter with diagnoses and procedures, rather than a dispensed prescription.

We already run another EMR. Can we still use it?

Yes. Doctor Billing takes claims in as an Excel file, so if your EMR can export in that format, it can feed the claims engine without being replaced. With EzDx the claim is assembled straight from the encounter record, which is cleaner.

Who does the coding?

The doctor, once, in the encounter — which is the point. Claims built from a clinician's own diagnosis and procedure record are rejected less often than claims transcribed by someone reading a note afterwards.

What happens to a rejected claim?

It appears with its denial reason, is corrected and resubmitted from the same screen, and is counted in the pattern report. Rejections are work items here, not write-offs at month-end.

See it on your own workflow.

Tell us which authority licenses you and what you run today. We'll configure the walkthrough for your market — thirty minutes, no slide deck.

A specialist replies within one working day

Onboarded in one day once you are ready

We review your data migration before you commit

EzPOSEzRxCCMSEzDxDoctor Billinge-InventoryAMS

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