The crew does the legwork. Your team decides.
Confirmity reads your payers every morning, checks every session and claim against six gates, and puts each open decision in front of the one person who owns it.
Monday · 7:00 AM
Scout found 6 rule changes. 2 affect your clients.
Dana WalshRevenue cycle lead
Michael signed the . Claim released to gate 06.
Scout read 6 payer sources at 06:04 . Checker drafted 1 follow-up. Nothing sent.Six gates. Every claim, every time.
A claim only goes out after it clears six checks, in order. When one fails, the claim stops there and the gap goes to a named person. Pick a gate to see what it checks.
Gate 01
Provider
Is the person who gave the service enrolled, credentialed and active with this payer on this date?
Checked byStafferLive sample
Example · stopped at gate 05
Jorge R. · IOP group · Tue Sep 29 · CPST 4 units. The is not signed yet. Michael ran the group and owns the signature. The claim waits until he signs.
What the app does, area by area.
One place for the work that usually lives in inboxes, spreadsheets and payer portals.
Rule changes
Payer rules, read every morning
Scout reads payer and state sources daily and shows which clients each change touches.
- Source, date and effective date on every change
- You decide what the center does
| Source | Change | Clients | Status |
|---|---|---|---|
| Sample payer | CPST prior-auth cut to 16 units · eff. Oct 1 SeverityHighImpactCaution | Jorge R. Maya T. | Waiting on you |
| Ohio Medicaid | Outpatient SUD prior authNeeds revalidation SeverityMediumImpactCaution |  Arjun K. | Waiting on you |
| Molina Healthcare | Telehealth place of service 02Future date SeverityLowImpactInformational | None | No impact |
Claims
Held before a denial, not after
Claims that would fail a gate wait in a queue with the reason and an owner. 
Auditor follows what was paid and what came back.
- Reason in plain words
- Fix it, then release it
| Client | Stopped at | Reason | Owner |
|---|---|---|---|
| Jorge R. | 05 Clinical | not signed | MichaelClinician |
 Diane L. | 04 Authorization | No units left on auth |  AngieIntake & UR |
 Sam P. | 01 Provider | Enrollment pending with payer |  JuanOwner · provider enrollment |
Scheduling and groups
Sessions that match the auth
Collector checks group size, units left and auth dates before the session is on the calendar.
- Units used against units approved
- Renewals flagged early
Jorge R.10 of 16 units usedMaya T.14 of 16 · Renewal due in 6 daysArjun K.5 of 16 units usedDiane L.16 of 16 · Held until renewalNotes and co-sign
Notes signed before they bill
Checker drafts the follow-up when a note is missing a signature or a co-sign.
- Supervisor co-sign queue
- Late-note reminders to the author
Jorge R. · IOP groupUnsigned“Michael, the needs your signature before the claim can go.”
SeverityHighImpactHold pathway
Maya T. · individualNeeds co-signMichael signed. Supervisor co-sign is next.
Grants and board
Grant rules and board packets
Auditor keeps the records each grant and board review asks for, in one place.
- Grant-funded services tracked apart
- Board view with no client detail
No client names on this view.
Reports
Proof for any auditor
Auditor keeps who decided what, when, and based on which source.
- Export by client, payer or date
- Every decision tied to a person
- Scout read Sample payer
- Scout matched 2 clients to the change
- Dana confirmed the new threshold
- Michael signed the
- Auditor filed the source with the decision
How a claim moves.
From the first referral to a paid, recorded claim. Agents prepare each step. A named person signs off. Scroll to follow Jorge's claim.
-
1
Referral and intake
Intake · CollectorChecking coverageIntake and Collector check coverage and open the case.
Angie confirms intakeIntake & URWaiting on AngieSigned off -
2
Authorization
CollectorTracking units and renewal datesCollector tracks the auth, units and renewal dates.
Angie submits the renewalIntake & URWaiting on AngieSigned off -
3
Sessions and notes
CheckerMatching the note to the serviceChecker matches the note to the service.
Michael signs the noteClinicianWaiting on MichaelSigned off -
4
Claim and payment
Collector · AuditorBuilding the claimCollector builds the claim. Auditor follows the payment.
Dana sends itRevenue cycle leadWaiting on DanaSigned off -
5
Record and audit
AuditorFiling the proofAuditor files the proof.
Juan reviews the fileOwner · provider enrollmentWaiting on JuanSigned off
Every role gets a seat.
At 7:00 AM each person sees only their part. Billing sees claims on hold. Clinicians see notes to sign. The board sees totals, never client names.
Clinical8
Medical directorPsychiatric NPClinical supervisorTherapistCase managerPeer recovery supporterBehavioral health techNurse
Money4
Revenue cycle leadBilling clerkIntake and URProvider enrollment
Housing and operations5
Program directorHouse managerResidential aideDriverFacilities
Leadership and oversight6
OwnerBoard memberCompliance and policyPrivacy adminRisk and safetyQuality committee
23 roles
How you start.
Most centers have the crew reading their payers within the first week. You confirm each step.
- 1
Guide sets you up
Your payers, programs, locations and staff list, typed in for you. You confirm each one.
PayersProgramsLocationsStaff list - 2
Scout reads your payers
Every payer and state source you bill, read every morning from day one.
Every morning - 3
The crew checks your work
Sessions, notes and auths run through the six gates. Each gap gets an owner.
Six gates - 4
You okay what goes out
Nothing is sent, changed or approved until a person on your team says yes.
DanaWaiting on you
Ohio Department of Medicaid
CareSource
Molina Healthcare
AmeriHealth Caritas
Scout read 6 payer sources at 06:04See it on your own payers.
Bring one payer and one program to a 30-minute walkthrough. We show you where the six gates would have stopped a claim.
Nothing sent without a person · Proof kept for audits