Preventable claim errors
Eligibility, demographics, rendering provider details, CPT data, modifiers, and authorization are checked before an EDI 837P file leaves the system.
Insurance claims and behavioral health RCM
Stop losing revenue to fixable denials
Rewire Clinical follows the claim from a signed note to payment. Your team can see what failed, who owns the next step, when an authorization expires, and whether the payer actually paid the expected amount.
EDI 837P claims, denials, prior authorization, ERA, and per diem billing are live.
78%
appeal success rate
CO-4
flagged before submission
94%
EAP progress by session 8
$40K+
recovered for a 6 clinician practice
14 days
earlier auth renewals
Where money gets stuck
A clean claim can still disappear into a messy process
Revenue leaks rarely announce themselves. A modifier conflicts with the service, an authorization quietly runs out, or an ERA pays less than the contract. Rewire turns each exception into visible work.
Denials with no owner
Every denied claim receives a reason, deadline, assigned owner, supporting documents, and a next action. Appeals remain visible through payer resolution.
Authorized care that is not billed
Attendance, census, approved level of care, remaining units, and per diem rules sit together, so delivered days are easier to reconcile before filing.
From note to payment
The claim starts with clinical work that is already complete
Once the note is signed, Rewire carries the correct service date, diagnosis, provider, location, and procedure details into claim preparation. Validation catches common mismatches. Accepted claims remain tied to payer acknowledgments, status, ERA, adjustments, patient responsibility, and the ledger.
- Claim scrub before EDI 837P submission
- Claim status and clearinghouse responses in one timeline
- Electronic remittance matched back to services
- Underpayment and zero payment exceptions surfaced for review
Live RCM capabilities
The details billing teams touch every day
EDI 837P claims
Build, validate, batch, and submit professional claims electronically. Clearinghouse acknowledgments and payer status stay connected to the original service.
Denials and appeals
Sort by reason, payer, dollar value, deadline, and owner. Correct and resubmit, or assemble an appeal and keep follow up dates visible.
Eligibility and benefits
Capture coverage and benefit details early, then keep the verification record with the client and episode of care.
Prior auth and level of care
Track authorization numbers, approved services, units or days, level of care, effective dates, renewal deadlines, and utilization review notes.
Remittance and reconciliation
Post ERA payments and adjustments, calculate patient responsibility, and send contract variance or underpayment exceptions for review.
Per diem billing
Connect attendance and census to authorized days for IOP, PHP, residential, detox, and substance use treatment billing.
Built for behavioral health
Private practice claims and facility billing belong in the same conversation
A group practice needs clean professional claims and fast denial follow up. A treatment program also needs level of care, authorization days, attendance, census, and per diem logic. Rewire supports both without forcing the facility team to recreate the clinical record in billing software.
A visible revenue cycle
Know the next action at each handoff
| Stage | What Rewire shows | Action |
|---|---|---|
| Before service | Eligibility, benefits, authorization, LOC, remaining units | Resolve coverage gaps |
| Before submission | Coding and claim validation | Correct errors before filing |
| After submission | Acknowledgment and payer status | Work stalled claims |
| After adjudication | ERA, payment, adjustments, contract variance | Post or investigate |
| After denial | Reason, deadline, owner, documents, appeal status | Fix, resubmit, or appeal |
Results
What the first 90 days can reveal
78%
Appeal success
Across appeals submitted through the Rewire denial workflow.
14 days
Earlier renewals
Average time gained when authorization expiry alerts replace calendar guesswork.
$40K+
Annual recovery
Average additional revenue recovered for a six therapist practice from fewer denials and faster appeals.
From billing teams
Less detective work, clearer follow through
“The denial queue changed our Monday meeting. We no longer read claim numbers from a spreadsheet. We work the highest value deadlines and know exactly who owns each one.”
“We recovered more than $40,000 in the first year. The bigger win is that we now catch the same coding problem before it becomes twenty denials.”
“Our PHP authorization list used to depend on one person remembering everything. Now the renewal work appears two weeks earlier and our UR team can act.”
Facility billing
Census and attendance become billable days without another rekey
Program staff document attendance and bed status as part of operations. Billing sees those records beside authorization dates and level of care. Exceptions stand out before month end, including an absent day, a changed LOC, or a renewal that needs utilization review.
Explore more
Follow the revenue cycle into the details
See how program billing, authorization work, and denials stay connected.
Plain language summary
A quotable summary of Rewire RCM
Rewire Clinical RCM is behavioral health billing software for electronic EDI 837P claims, claim status, ERA reconciliation, denial correction, appeals, prior authorization, level of care tracking, and per diem billing. It connects billing work to signed clinical notes, attendance, census, and the client ledger.
Questions
Behavioral health billing questions
Yes. Rewire submits professional claims electronically in EDI 837P format and connects claim status and electronic remittance to the client ledger.
The denial queue groups claims by reason, deadline, payer, owner, and next action. Teams can correct and resubmit claims or track an appeal through resolution.
Yes. Rewire tracks approved units or days, level of care, effective dates, utilization review notes, renewal dates, and remaining authorization.
Yes. IOP, PHP, residential, detox, and addiction treatment programs can connect attendance and census data to authorized days and per diem billing.
Yes. Claims, remittance, denial management, appeals, prior authorization, level of care tracking, and per diem workflows are available in Rewire Clinical. See the RCM overview for a shorter introduction.