Catch issues before you bill.
Automatically check every visit for problems that would cause claim denials, payment delays, or compliance violations -- before you submit anything.
What Pre-Billing QA Does
Pre-Billing QA automatically checks every visit for issues before you submit it for billing. It runs across six categories of potential problems and assigns a severity level to each one.
The goal is simple: catch the problems that would cause claim denials, payment delays, or compliance violations before they reach the payer. Fix them in seconds instead of dealing with rejections weeks later.
Issue Categories
Every visit is scanned across six categories. Each category targets a different type of problem that could block or delay payment.
Signature
Missing patient or caregiver signatures on completed visits. Signatures are required for most payer types before a claim can be submitted.
Documentation
Incomplete visit notes, missing required fields, or empty care task records. Documentation gaps are the leading cause of claim denials.
EVV
EVV export issues, GPS or geofence problems, missing clock-in/clock-out data. Only flagged when EVV is enabled for the patient or payer.
Authorization
Missing or expired prior authorizations. If a payer requires prior auth, visits without a valid authorization will be flagged before billing.
Billing
Missing billing rate, service code, or visit duration. These fields are required to generate a claim or invoice for the visit.
Insurance
Missing insurance information when required for a claim. If the patient is set to insurance billing, their policy details must be on file.
Severity Levels
Not all issues are equal. Severity levels help you prioritize what to fix first.
Must fix before billing. These issues would cause claim denials or payment rejections. The visit cannot be submitted until all critical issues are resolved.
Should fix before billing. These may cause payment delays, partial denials, or require manual follow-up with the payer after submission.
Heads up. Not blocking and won't prevent billing, but worth reviewing. These are informational flags that may indicate data quality issues.
Hard Gate Mode
Hard Gate Mode is a toggle that blocks all billing submissions until critical issues are resolved. It gives you strict control over what leaves your agency.
Only completely clean visits can be submitted for billing. Visits with critical issues, warnings, or info flags are all blocked until resolved.
Visits with warnings and info flags can proceed to billing. Only critical issues remain as hard blockers that prevent submission.
Batch Submit
Once your visits are clean, click "Batch Submit Clean Visits" to mark all eligible visits as billed at once. No need to open each visit individually and mark them one by one.
The batch submit button only includes visits that pass your current gate settings. If hard gate mode is on, that means zero issues across all severity levels. If hard gate mode is off, that means zero critical issues. Either way, you know exactly what's being submitted.
Filtering
Date range presets
Filter by today, this week, this month, last 7 days, last 30 days, or set a custom date range.
Severity filter
Show only critical, warning, or info issues. Focus on what matters most first.
Category filter
Filter by issue category: signature, documentation, EVV, authorization, billing, or insurance.
Patient / caregiver filter
Narrow results to a specific patient or caregiver to fix issues for one person at a time.
Search
Free-text search across visit details, patient names, caregiver names, and issue descriptions.
Workflow
The full pre-billing QA workflow, from reviewing issues to submitting clean visits.
Navigate to Pre-Billing QA
Open the Pre-Billing QA page from the billing section. You'll see summary cards showing issue counts by category and severity.
Review summary cards
Summary cards show total visits with issues, broken down by severity level. Critical issues are highlighted at the top so you can prioritize.
Fix critical issues
Click any flagged visit to jump directly to the visit detail or patient page where you can fix the issue. Add missing signatures, complete documentation, or update authorization info.
Return and verify
Come back to Pre-Billing QA. Fixed issues disappear from the list automatically. Repeat until all critical issues are resolved.
Batch submit clean visits
Click "Batch Submit Clean Visits" to mark all eligible visits as billed at once. Only visits with zero critical issues (and zero warnings if hard gate is on) are included.
Redirected to billing dashboard
After batch submission, you're redirected to the billing dashboard where you can track submitted claims, invoices, and payment status.
Stop chasing claim denials.
Pre-Billing QA catches the issues that cost you time and money. Try it in the demo or get started today.