Billing pipeline
How a documented encounter becomes a submitted claim and a posted payment, and where it can stall along the way.
The billing pipeline is the path from documented care to money in the bank. Vantrexia exposes each stage so you can see where work is stuck rather than discovering a problem at month end.
The stages
Encounter
A documented, attested interaction. Comes from an attested Voice Scribe note, a resolved escalation, or a manually logged call.
Billing entry
The encounter is matched to a CPT code and a billing period. RPM and CCM ladders are evaluated separately.
Review
Entries sit in the work queue for a biller to approve or void. Voiding is a deliberate decision not to bill.
Scrub
Approved entries pass a pre-submission scrubber that checks coding edits before anything reaches a payer. Catching a problem here is far cheaper than a denial.
Submit
Clean claims are batched and submitted to the clearinghouse.
Remit
Electronic remittance advice comes back and posts against the claim in the ERA Inbox. Denials route to the denials queue.
Where things stall
| Symptom | Usual cause |
|---|---|
| Patient has no billing entry | Fewer than 20 documented minutes, or the note was never attested. |
| Entry stuck in review | Waiting on a biller to approve. Check the work queue. |
| Claim rejected before reaching the payer | Scrubber or clearinghouse validation. The rejection message names the field. |
| Claim submitted but nothing posts | No ERA received yet, or a remittance that did not match the claim. |
| Denial | Worked from the denials queue, not from the pipeline view. |
The Command Center
The Billing Command Center is the single view over all of this: total revenue, accounts receivable, collection rate, denial rate, claims submitted, and accounts receivable aging by bucket. Quick actions jump you into the queue that needs attention.
Numbers on the Command Center describe your whole practice for the period you select, not the page you are looking at.