EDiFi End to End:
Patient Scheduled to Revenue Recovered

Coverage Confirmed Before They Arrive. EDiFi verifies insurance coverage in real time — not the night before, not at check-in, but automatically as soon as the appointment is scheduled. Benefit breakdowns, deductibles, frequencies, and missing tooth clauses are all surfaced and documented before the patient walks through the door.

Claims Built from Clinical Data, Not Memory. After treatment, EDiFi's AI claim scrubber reads the clinical documentation and auto-assigns CDT procedure codes and ICD-10 diagnosis codes. Every claim is formatted to that specific payer's submission requirements. Coding errors, missing modifiers, and invalid code combinations are caught before submission — not after denial.

Every Payment Audited Against Your Fee Schedule. When the insurance EOB arrives, EDiFi's Payment Audit Engine automatically compares what was paid against your contracted rate for every procedure, every payer, every time. This is the step that found $59,000 in underpayments across 2,399 claims in a single practice — discrepancies a billing team never had time to catch manually.

Underpayments Flagged. Appeals Automated. Every discrepancy is classified as Collectible, Appealable, or Adjustable and routed to the right action queue. EDiFi generates appeal letters with clinical context specific to the denial reason and the payer's known objections. The appeal engine learns which arguments win — improving recovery rates over time.

Revenue Recovered. Full Visibility. The analytics dashboard shows exactly how much was recovered, which payers are underpaying systematically, which procedures are most frequently denied, and where your billing team should focus next. This is the intelligence layer that turns your revenue cycle from a cost center into a competitive advantage.