Payer adjudication
Submitted charges, adjustments, deductible, copay, coinsurance, and patient responsibility.
Submitted $440.00Adjustment−$246.76Patient share $193.24
Remove the manual first pass from medical bill review.
Cenrus connects payer adjudication, provider bills, and available payment evidence. Review teams get a clear verdict and the evidence behind it.
Built for medical bill review and patient advocacy teams with active queues.
01
Payer adjudicationPatient responsibility
$193.2402
Provider requestStatement balance
$440.0003
Payment evidenceNo supported record
—VerdictReview required
Amount discrepancy
$246.76 differenceHighmatch
ProviderService dateAccountAmount
Reconstruct the financial state before you review the case.
A medical bill is a request for payment, not proof that it matches the payer's decision. Cenrus connects the provider request, payer adjudication, and available payment evidence without treating any one source as complete.
Provider request
The requested balance with account, provider, service date, and charge details when available.
Payment evidence
Supported receipts, transactions, and payment records supplied through the customer workflow.
Evidence attached
Move human review to the cases that need judgment.
Cenrus performs the repetitive first reconciliation. Reviewers handle discrepancies, uncertainty, and the cases where context matters.
Current workflowEvery bill
- 01Identify the insurance plan
- 02Find the relevant claim
- 03Read and interpret the EOB
- 04Match the claim to the bill
- 05Compare each financial value
- 06Decide whether to investigate
With CenrusFocused queue
Routine casesClassified with evidence
ExceptionsPrepared for reviewer judgment
Reviewers start with the relevant claim, compared values, matching signals, and recommended action.
Make the decision fit the records.
Cenrus returns focused verdicts such as consistent with payer, amount discrepancy, claim not found, responsibility changed, ambiguous match, and human review required. Every verdict explains the result.
- 01 Financial values and allocation
- 02 Provider, date, account, and service signals
- 03 Match confidence and ambiguity
- 04 Recommended reviewer action
Decision evidence4 matching signals
ProviderMatchedExact
Service dateFeb 27, 2026Exact
Patient account•••• 7291Exact
Requested amount$440.00Differs
Compared with payer responsibility$193.24
Track payer responsibility when the claim changes.
A one-time review becomes outdated after claim reprocessing. Cenrus compares the previous and current adjudication, records the new payer state, and emits an event.
$1,240 patient responsibility
The payer assigns an amount to the patient.
$1,240 requested
The provider request matches the payer record at that time.
$0 patient responsibility
Cenrus detects the change and sends the case back for review.
A pilot proves how much work Cenrus removes.
Cenrus compares its output with the customer’s existing process to measure coverage, reviewer agreement, and work removed.
Queue coverage
Measure how often the queue contains accessible and detailed payer adjudication data.
Reviewer agreement
Compare each Cenrus verdict with the reviewer’s decision and record every override.
First pass removed
Track the share of bills that no longer need the current manual first pass.
Minutes returned
Measure reviewer time saved on routine cases and time reduced on exceptions.