Sign the Note. Get Paid Automatically.
The entire billing cycle — from the moment you sign a visit note to the moment payment posts to the patient account — runs on autopilot. Claims are built, scrubbed, uploaded, and paid without anyone manually touching them.
No billing degree. No clearinghouse coordinator. No stacks of paper. One person can run the entire operation from day one.
Six Steps. Zero Manual Work.
Every step in the billing lifecycle runs automatically. You do the clinical work. The system handles the money.
Sign the Note
Provider signs the visit note. AI has already reviewed codes, caught denial risks, and pre-filled everything.
Claim Auto-Built
A clean claim is instantly constructed from the signed note with codes, modifiers, demographics, and fee schedule amounts.
Scrubber Validates
Every claim is automatically run through the claims scrubber before it ever leaves your office. Errors get caught here.
Auto-Upload to Clearinghouse
Clean claims batch-transmit automatically via SFTP to Claim.MD or Office Ally. No manual uploads. Ever.
ERA Auto-Downloaded
When the insurer sends payment, the 835 ERA file is automatically retrieved from the clearinghouse and parsed.
Payments Auto-Posted
Exact-match ERA payments post automatically to the correct patient accounts. No data entry. No manual matching.
One-Click Full Cycle
Do not want to think about any of it? Hit Run Full Billing Cycle and the system automatically scrubs all draft claims, submits ready ones to the clearinghouse, downloads any outstanding ERAs, and auto-posts exact-match payments. Everything happens in a single click. Walk away and it is done.
Sign the Note. Claim is Built Instantly.
When you complete a visit and sign the note, the system immediately begins building the insurance claim. There is no separate billing screen. No re-entering diagnoses. No hunting for procedure codes. Everything that was documented in the visit automatically flows into the claim.
The result: By the time you move to your next patient, the claim is already built, validated, and sitting in the ready queue — waiting for the nightly batch to the clearinghouse.
Every Claim Validated Before It Leaves.
The claims scrubber is your last line of defense before a claim reaches the payer. It runs automatically on every single claim the moment it is created. If something is wrong, the system flags it with a plain-language explanation and, for most common issues, offers an automatic fix.
This is how CareMetric achieves a 98.7% clean claim rate. Not because billers are perfect — because the scrubber catches what humans miss before any human has to be involved.
For the most frequent scrub failures — missing place of service, unlinked diagnosis codes, uncalculated totals — the system offers a one-click auto-fix. It corrects the error and moves the claim to ready status automatically. No manual rework.
Claims Upload Automatically. Nothing to Send.
Once claims pass the scrubber, they batch into an EDI 837P file — the industry-standard HIPAA-compliant claim format — and transmit automatically to the clearinghouse. No portals to log in to. No files to upload manually. No phone calls to the clearinghouse.
- Real-time eligibility verification
- Instant claim acknowledgment (997)
- ERA auto-download on payment
- Rejection response with reason codes
- SFTP batch upload of 837P files
- Automatic nightly transmission
- ERA/835 download on schedule
- Payer network of 5,000+ insurance plans
Payments Download and Post Automatically.
When the insurance company sends payment, they include an Electronic Remittance Advice (ERA) file — a standardized EDI 835 document that explains exactly what was paid, what was adjusted, and what the patient owes. CareMetric retrieves this file automatically, parses every line, and matches it back to the original claims without you doing anything.
For claims where the match is exact — claim number to claim number — the payment posts automatically. Paid amount, allowed amount, adjustment codes, and patient responsibility are all recorded precisely. The claim closes. No manual entry. No hunting through an explanation of benefits.
What Gets Recorded on Every Posted Payment
When an ERA shows a patient responsibility balance and secondary insurance is on file, the system automatically creates and queues the secondary claim. You do not have to track it. It happens the moment the primary ERA posts.
Denials Get Fixed. Automatically.
Every denial is automatically identified from the ERA, translated from insurance jargon into plain English, and queued for resolution with an AI-suggested fix. Most denials are resolved with one click.
Denial reason auto-identified
CARC and REMARK codes translated into plain English immediately
AI suggests the exact fix
For 95% of denials, the system tells you what to change and how
One-click correct and resubmit
Apply the fix and resubmit without re-entering any data
30-day appeal follow-up auto-scheduled
Never miss an appeal deadline again
Denial trend analytics
See which payers deny most, which codes get flagged, and why
Appeal success rate tracked
Know your recovery rate and the financial impact of every denial category
Anyone Can Do This. That is the Whole Point.
CareMetric was built so a solo provider, a new graduate, or a front desk coordinator with zero billing experience can run a complete, compliant revenue cycle without help. The system was designed from the ground up to remove every place where specialized knowledge was previously required.
One person runs the whole operation
No billing department. No coding staff. No clearinghouse coordinator. One person can manage the entire revenue cycle from intake to payment. The system handles every repetitive step automatically.
No billing certification required
The claims scrubber catches errors so you do not have to know every payer rule by memory. AI tells you what codes to use and flags anything that looks wrong before it leaves your office.
AI guides every decision
When a claim fails scrubbing, the system shows exactly what is wrong and how to fix it. When a denial comes back, AI identifies the reason and suggests the correction in plain language.
Simplified dashboard mode
Do not want the advanced RCM interface? Use simplified billing mode. A single-screen view shows you what needs attention, with a "Run Full Cycle" button that scrubs, submits, downloads ERAs, and posts payments in one click.
Nothing falls through the cracks
A biller workqueue surfaces every item that needs human attention: scrub errors, unmatched ERAs, pending appeals. Everything has a priority level and a due date so nothing ages in a queue forever.
Secondary claims automatically queued
When a primary payer leaves a patient balance, the system identifies secondary insurance and queues the secondary claim automatically. You do not have to track it manually.
Two Modes for Two Types of Practices
Single-screen view with the most important information. One "Run Full Cycle" button handles everything. Designed for solo providers and small practices where one person wears every hat. No complexity. Just results.
Full control over every step of the revenue cycle. Separate tabs for the pipeline, 837P generation, submission tracking, ERA posting, and secondary claims. For billing staff and larger practices that want maximum visibility.
Coverage Verified Before You Even Start
Insurance errors are the number one cause of claim denials. CareMetric verifies coverage at three automatic checkpoints so there are never surprises at billing time.
Calculate your billing recovery potential
See how much revenue you are leaving on the table with your current billing process.
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Ready to Never Think About Billing Again?
Start your free trial and experience a billing cycle that runs itself. Sign a note today. Get paid automatically. That is it.