Capsa Coding Pipeline
Capsa Pipeline · for revenue-cycle leaders

Watch the charge-to-claim lifecycle, end to end.

The control tower. Every visit tracked from attended encounter to dropped claim — the lags and bottlenecks before they age, the charges Capsa captures that would have slipped, and the rules that keep claims clean.

Throughput, lags & aging — the whole pipeline, live Captured charges, quantified vs the coder
capsa pipeline · monitoring
Capsa Pipeline home: pipeline-health KPIs and a throughput-per-day chart
The mid-cycle blind spot

The gap between the visit and the bill is invisible.

Between a signed note and a dropped claim, work stalls in places no one can see — until it shows up as aged AR or a denial.

No visibility

Where are charges stalling?

Which visits are aging, which providers never answer queries, which coders are the bottleneck — spreadsheets and gut feel don't scale.

Unknown leakage

What did we miss — or over-bill?

The charges the documentation earned that never made the claim, and the codes that would clean it up before it's sent — invisible without a check on the whole path.

TakeawayYou can't fix the lag, the leakage, or the denial risk you can't see.
Monitor the pipeline

The whole pipeline, on one screen.

Visits processed, charge lag, reconciliation, query rate, and aging — for any window — plus throughput per day so you see volume and dips immediately. Drill into any encounter from here.

capsa pipeline · pipeline health & throughput
Pipeline health KPIs and a throughput-per-day bar chart over the last three months
Health at a glance. Volume, lag, query rate, aging — and the daily throughput behind them.
capsa pipeline · reconciliation
Reconciliation: every visit in a known state, with how many are overdue and how long the oldest has waited
Nothing slips through the cracks. Every visit in a known state, the longest-waiting surfaced, and billing-lag & turnaround KPIs in one strip.
The value Capsa adds

The charges that would have slipped — quantified.

Capsa's defensible code set next to what was billed: where they agree, where Capsa caught more (potential captured revenue), and where the claim had codes to review.

capsa pipeline · Capsa vs. coder
Capsa vs coder: both agreed, Capsa-only captured charges, coder-only, and agreement percentages
Capture, on the record. “Capsa-only” lines are charges the claim missed. Compare against billed claims or workbench-finalized sets — agreement, honestly labeled, not a grade.
capsa pipeline · provider responses
Provider responses: notification delivery and per-coder query activity with close rates
Know who's moving the queue. Which providers respond quickly, which coders ask a lot — and who never asks, leaving capture on the table.
Payer scrub rules

Clean the claim before it's billed — deterministically.

Deterministic claim-scrub rules grouped by payer: draft, preview the impact on your billed corpus, then activate. The same rule runs the same way every time — and Capsa can draft them for you from a payer bulletin.

capsa pipeline · payer rulesets
Payer rulesets grouped by payer scope, with draft and active status
Rules, under your control. Grouped by payer, versioned, preview-then-activate.
capsa pipeline · draft rules from a bulletin
Drafting payer rules from a bulletin: Capsa proposes deterministic rules each justified by a verbatim quote
Bulletin to rules in minutes. Paste the policy → Capsa drafts deterministic rules, each justified by a verbatim quote. The AI only authors — it never runs at scrub time.
Coverage & governance

See what Capsa covers — and run the operation.

Explore the coding guidelines in use and where coverage is expanding; manage people, licensing, access, and the audit trail.

capsa pipeline · the coverage map
The coverage map: coding component by care setting, with ambulatory live and ED, imaging and inpatient on the roadmap
What Capsa codes — and what's next. Component by care setting: pediatric ambulatory is live today; the filled cells grow as coverage expands.
capsa pipeline · users & access
The user directory with roles, permissions, status, and last sign-in
Operations, governed. People directory, licensing and access, and categorized error & audit logs across the engine and apps.
Defensible by design

Built for the audit.

Deterministic scrub

Scrub rules are explicit data, not a model guess. The AI only authors a draft from a payer bulletin; at run time the engine is deterministic and reproducible.

Every state on the record

Each visit moves through a known set of states, every transition stamped — so reconciliation is by construction, not a monthly reconciliation project.

A code set, not a claim

Capsa produces a payer-ready code set; your PM system stays the system of record that drops the claim. No rip-and-replace, no lock-in.

What leaders get back
Capture, quantified

the charges Capsa adds that the claim missed — counted on your own visits.

“See the lag, the leakage, and the denial risk — before they cost you.”

Bottlenecks, visible Charge lag and aging surface where work stalls; provider and coder activity shows why. The fixes are obvious once you can see them.

Honest by design: capture figures are counts of code differences and opportunities to review — not guaranteed dollars. You confirm the value on your own visits.

Find out more

See your charge-to-claim lifecycle.

Tell us about your revenue-cycle operation and we'll show you the pipeline on your own visits — the lags, the leakage, and the capture.

  • Throughput, charge lag & aging, live
  • Captured charges quantified vs the coder
  • Deterministic payer scrub rules
  • No PM-system or vendor lock-in
[email protected] · capsacoding.com

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