Prototype Synthetic billing simulation · no live PHI · no real claims · biller does not approve clinical decisioning · switch role
Biller Workspace/Commercial / Provider Invoice ledger
Export Synthetic packet BL

Today · 38 candidates

Billing dashboard

Documentation and billing readiness across the panel. Biller does not autonomously approve clinical decisioning, generate CPT, or write to clinical workflow.

Ready to bill

22

+5 today

Needs documentation

9

−2

Needs provider review

5

flat

Denial risk

2

−1

Closure rate (30d)

87.4%

+3.2pt

Median time-to-bill

11d

−4d

Top patient candidates

PatientDocumentationBilling readinessPayer
JP-DEMO-0042 Evelyn JohnsonPending providerNeeds docMedicare Advantage
JP-DEMO-0068 Maria CastanedaCompleteReadyMedicare Advantage
JP-DEMO-0088 Antonia SinghCompleteReadyOriginal Medicare
JP-DEMO-0073 Desmond HenriquezMissing consentDenial riskDual SNP
JP-DEMO-0105 Florence NguyenCompleteReadyMedicaid Managed

Closure rate (12w)

Ready Needs doc Provider review Denial risk

38 candidates

Billing queue

#PatientServiceDocumentationStateTime-to-close
1JP-DEMO-0068Care navigationCompleteReady3d
2JP-DEMO-0088Smart visitCompleteReady4d
3JP-DEMO-0105Care plan refreshCompleteReady5d
4JP-DEMO-0042Smart visit · homePending providerNeeds doc
5JP-DEMO-0051Home assessmentPending providerNeeds doc
6JP-DEMO-0073Barrier follow-upMissing consentDenial risk

9 patients need documentation

Documentation review

  • JP-DEMO-0042 · awaiting provider sign-off on hybrid note
  • JP-DEMO-0051 · CHW field photo missing
  • JP-DEMO-0073 · telehealth consent missing
  • JP-DEMO-0088 · time log incomplete
  • JP-DEMO-0097 · plan version not refreshed
  • JP-DEMO-0105 · referral closure summary needed
  • JP-DEMO-0117 · provider attestation needed

CPT candidate state

Claims readiness

Biller does not generate CPT autonomously. Provider sign-off is required for any candidate to advance.

PatientCPT candidateProvider sign-offEvidenceState
JP-DEMO-006899490 (CCM 20m)SignedREF-EV-0046Ready
JP-DEMO-008899491 (CCM 30m)SignedREF-EV-0050Ready
JP-DEMO-004299490 (CCM 20m)PendingREF-EV-0042Hold
JP-DEMO-0073Blocked (consent)

Commercial ledger only

Provider invoices

InvoiceProvider groupPeriodAmountState
INV-2026-05-001Provider Group DemoMay 1–15$ — (synthetic)Sent
INV-2026-05-002Provider Group DemoMay 16–31$ — (synthetic)Drafting
INV-2026-04-002Provider Group DemoApr 16–30$ — (synthetic)Paid

No real currency amounts. No real payer mapping.

2 denials this period (synthetic)

Exceptions

  • EX-001 · JP-DEMO-0073 · consent missing · routed back to provider review
  • EX-002 · JP-DEMO-0117 · provider attestation timestamp mismatch

Synthetic exception examples · no real claims.

Documentation analytics

Reports

ReportPeriodCadence
Documentation completeness rollup30d rollingWeekly
Provider attestation latency90d rollingMonthly
Denial-risk pre-flight60d rollingBi-weekly
Payer-mix overview (synthetic)QuarterlyQuarterly

Workspace

Settings

Auto-flag denial risk Block CPT generation without provider sign-off Allow biller-driven clinical decision (PROHIBITED) Audit emission required

Biller-driven clinical decision toggle is intentionally locked off. Production policy prohibits it.