Prepare cleaner claim resubmission packets.
Staff rebuild denied claims from scattered documents.
Est. deploy 4–6 weeksSee the walkthrough
Back Office & Finance · Orthodontics
Resolve payment exceptions before balances grow.
Failed installment payments are noticed late.
For: Billing coordinators and the team responsible for back office & finance in orthodontics.
01 · The outcome
What good looks like.
The team has a reviewed payment exception queue with an owner and next action, with source evidence and an explicit approval before any external action. Track days to resolve failed installments against a baseline; do not assume automation improves it.
A connected workflow that uses payment failure code, payment-plan terms, and prior outreach to separate expired-card issues from disputed charges and draft an administrative follow-up. It produces a reviewed payment exception queue with an owner and next action.
Where AI helps, and where a person decides.
AI can separate expired-card issues from disputed charges and draft an administrative follow-up. It drafts and organizes; it does not authorize spending, commitments, clinical decisions or customer communication. The billing coordinator verifies the source facts and approves the final action.
Billing coordinator is accountable. People approve customer-facing, sensitive, financial, and legally binding actions.
- Billing coordinator: Capture the source and scope
- Billing coordinator: Review the proposed outcome
- Billing coordinator: Release only the approved version
- Billing coordinator: Check the result and exceptions
A named person approves customer-facing messages, spending, record changes and binding commitments before release. Pre-approved scripts are versioned; exceptions stop for review.
02 · The handoffs
How the work moves.
Every handoff has an owner. Select a step to open or close its detail.
Start when: An installment charge fails. Connect only payment failure code, payment-plan terms, and prior outreach. The billing coordinator confirms the request is authorized and in scope.
Ready when: The source reference, permissions and accountable owner are recorded.
Use the authorized records to separate expired-card issues from disputed charges and draft an administrative follow-up. Preserve the original language alongside the draft and label uncertain fields.
Ready when: Each proposed fact links back to a source, and missing information is visible.
Check a reviewed payment exception queue with an owner and next action against the original records and current policy. Correct errors and escalate exceptions to the qualified specialist; do not auto-approve.
Ready when: Billing coordinator has recorded approval or a reason to hold the item.
After explicit approval, save a reviewed payment exception queue with an owner and next action in the system of record. Send only approved messages to verified recipients. Record the version and prevent duplicate delivery.
Ready when: The approved record is saved; any delivery is confirmed or placed in the retry queue.
Review days to resolve failed installments each week, sample completed records for quality, and resolve held items. Change the rules only after reviewing actual errors and staff feedback.
Ready when: Exceptions have owners, the metric has a baseline, and corrective actions are assigned.
Sample record.
$ david run --workflow=ortho-payment-exceptions
ILLUSTRATIVE RECORD / NOT LIVE CUSTOMER DATA
- Example
- Illustrative only — not a real client record
- Reference
- ORTHO-PAYMENT-EXCEPTIONS-DEMO-001
- Trigger
- An installment charge fails.
- Owner
- Billing coordinator
- Prepared output
- a reviewed payment exception queue with an owner and next action
- Review status
- Awaiting human approval — no external action taken
- Missing information
- Owner to verify source completeness
- Measure
- Days to resolve failed installments
Start with your tools.
Connect Practice management system, Google Calendar, Secure messaging through approved APIs or controlled exports. Map record identifiers first; test permissions and field updates in a sandbox. Vendor names describe possible connections, not a guarantee of an available integration or license.
When things go wrong.
- A named person approves customer-facing messages, spending, record changes and binding commitments before release. Pre-approved scripts are versioned; exceptions stop for review.
- Use only authorized sources and role-based access. Keep an audit trail of source records, drafts, approvals and delivery status; deduplicate retries.
- If an integration fails, a source is missing or confidence is low, pause the action and assign the original request to the accountable owner.
- For healthcare uses, validate HIPAA applicability, execute required BAAs, restrict PHI to the minimum necessary, and use approved secure systems. Clinicians handle symptoms, urgent care and clinical decisions.
Try this week / no DAVID required
A useful first step.
This week, have your billing coordinator time five examples of this work. Use redacted copies of payment failure code, payment-plan terms, and prior outreach to make a reviewed payment exception queue with an owner and next action manually, then list which fields required judgment.
What to measure.
- Days to resolve failed installments
- Minutes of human handling per completed item
- Drafts needing substantive correction
- Exceptions unresolved beyond the agreed review window
Estimate your time back.
20.8
$11,232
03 · More workflows to consider
Related workflows.
Find recurring causes of claim denials.
The same preventable denial keeps returning.
Est. deploy 4–6 weeksSee the walkthrough
Check billing narratives before invoices leave.
Invoices contain vague entries or privileged details.
Est. deploy 4–6 weeksSee the walkthrough
Want this running in your business in 4–6 weeks?
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