Insurance Claim Follow-Up Bot

Key facts

• Price: $49/mo
• Category: business
• Environment: nanoclaw
• Tags: insurance-claims, revenue-recovery, medical-billing, dental-billing, claim-follow-up, denial-management
• Seller: ClawHQ

What it does

The average medical practice has $47,000+ in claims older than 60 days. Insurance companies process tens of millions of claims annually — they count on yours falling through the cracks. When you don't follow up, they don't pay. ClaimBot is the most persistent billing advocate you'll ever hire, generating compliant follow-ups, escalations, and complaint letters until claims get paid. ## What's included - **Aging buckets dashboard** — 0-30, 31-60, 61-90, 91-120, 120+ day claims with $ at risk per bucket, payer breakdown, and trending direction week-over-week - **30-day first follow-up letters** — payer-specific format (Aetna, BCBS, UHC, Cigna, Medicare, Medicaid); CPT + ICD-10 codes referenced, claim number indexed - **45-day escalation letters** — references first follow-up, requests written response, references state prompt-pay statute where applicable - **60-day formal demand** — references state prompt-pay timeline (most states 30-45 days), requests interest accrual where statute provides - **90+ day complaint preparation** — state Department of Insurance complaint draft + payer-specific provider relations escalation; most claims pay before the complaint is filed - **Denial appeal letters** — by denial reason code: medical necessity (with literature citation hooks), bundling, timely filing, prior auth, coordination of benefits; payer-specific appeal addresses + fax numbers - **Underpayment recovery** — surfaces claims paid less than contracted rate; generates rate-correction request with fee schedule reference - **CMS-1500 + UB-04 corrected claim assistant** — line-item adjustment workflow when resubmitting - **Payer behavior tracker** — which payers slow-pay specific CPT codes, which require redundant documentation; intelligence file you can take into contract renegotiation - **Weekly action queue** — every Monday: "these 14 claims hit 30 days this week, send first follow-ups" ## Limitations - **Not a clearinghouse** — pairs with Availity / Change Healthcare / Waystar for actual claim submission; ClaimBot is the AR follow-up layer - **Not an EHR** — pulls claim status from payer portals + your AR export; doesn't replace eClinicalWorks / Epic / Athena - **Not legal counsel** — DOI complaints + provider contract enforcement; serious payer abuse (RICO, breach of contract) needs healthcare attorney - **Single-TIN scope** by default — multi-entity hospital systems run per-TIN sessions - **U.S.-payer-focused** — CMS prompt-pay + state DOI; Canadian / UK / AU payer systems entirely different ## Best fit Medical practices, dental practices, chiropractors, physical therapists, mental health providers, durable medical equipment suppliers, ambulatory surgery centers, and auto body / collision shops working with insurance — anyone who files claims and waits for payment. Especially valuable for solo + small practices without dedicated AR staff where claims older than 60 days are quietly written off as bad debt; practices using ClaimBot consistently report recovering $15,000-$50,000 in the first 90 days from claims that would have aged to zero. At $79/mo, the breakeven is a single recovered $500 claim.