AIFY is a add-on SaaS ledger that lets a practice collect what it is actually owed by building complete, accurate claims that carry every piece of data the carrier requires, and by calculating exact patient copayments at the same time.
1 · connects to the software you already run
AIFY integrates with your practice management system and brings insurance eligibility in with it — resolved against the parameters set by that individual carrier and that individual plan, not a generic benefits summary. Coverage rules, frequency limits, waiting periods, annual maximum, deductible and downgrade policy arrive as the specific terms that apply to that patient.
2 · The treatment is checked, code by code
Each procedure runs through the coverage rules for that patient's plan: is it covered, at what percentage, is the frequency limit already used, has the waiting period passed, does it downgrade to a cheaper alternative, does the annual maximum still have room.
3 · The copay is calculated
What insurance is expected to pay and what the patient owes, with secondary insurance resolved through the correct coordination-of-benefits formula. The front desk quotes a number it can stand behind.
4 · The claim is checked before it goes
Fourteen pre-submission checks. Errors block submission; warnings require acknowledgement. Every alert and every acknowledgement is logged.
5 · The ledger stays current
Payments and write-offs post against the claim. Deductibles and annual maximums update as they are consumed. Denials are recorded and grouped by carrier, code and reason, so the pattern becomes visible instead of anecdotal.