01
Connect payer access
The patient authorizes the payer connection. Cenrus synchronizes the available claim and EOB records.
Move routine cases out of the reviewer queue.
Cenrus finds the relevant payer adjudication, compares it with the provider request, and tells reviewers which cases require investigation.
Review queue
Consistent with payerRoutine path
Amount discrepancyReviewer
Ambiguous matchReviewer
Claim not adjudicatedWait
Every bill receives the same manual first pass.
Reviewers spend time reconstructing the financial state before they know whether a case is routine or complex.
- 01
Identify the insurance plan
- 02
Find the relevant claim
- 03
Read the EOB
- 04
Interpret payer adjudication
- 05
Match the claim to the bill
- 06
Compare each financial value
- 07
Decide whether to investigate
- 08
Start the investigation
The first seven steps find and interpret evidence. Cenrus performs this work before the reviewer opens the case.
Give each case the right path from the start.
Cenrus connects patient-authorized payer data with the bill and any available payment evidence.
02
Send the provider bill
The customer provides the bill and any account or payment context already available in its workflow.
03
Reconcile the records
Cenrus matches the claim, rebuilds the payer allocation, and compares the provider request.
04
Route the result
Routine cases receive a classification. Exceptions arrive with the relevant evidence assembled.
Scenario model
Queue transformation
Set your operating assumptions to estimate how much routine first-pass work leaves the manual queue.
Your assumptions
Bills entering the current review queue
Reviewer time spent before deeper review
Share of bills with enough payer evidence to assess
Share of reconcilable bills classified as routine
Hourly labor cost used for this estimate
Reconcilable bills
1,800
With usable payer data
First pass removed
1,224
49% of the queue
Queue remaining
1,276
Exceptions and data gaps
Reviewer hours returned
163.2
Estimated each month
Monthly queue
Every bill starts in the manual first pass.
2,500 bills
Routine first pass removed1,224 bills
Exceptions prepared for review576 bills
Usable payer data unavailable700 bills
Estimated monthly labor value
$8,486
Modeled monthly labor value based on the assumptions above.
Calculation
2,500 bills × 72% usable data × 68% routine
= 1,224 first passes removed
1,224 × 8 min ÷ 60 × $52/hr
= $8,486 estimated value
Automate routine classification. Prepare the exceptions.
The first verdict set stays narrow so each result maps to a clear review action.
Consistent with payer
The provider request agrees with payer adjudication based on the records and match evidence available.
Amount discrepancy
The requested amount differs from the payer assigned responsibility or financial allocation.
Claim not found
The available payer records do not contain a supported match for the provider request.
Claim not adjudicated
A related claim exists, but the payer has not completed the financial decision.
Ambiguous match
More than one candidate or conflicting signals prevent a reliable association.
Human review required
An evidence gap or customer rule sends the case directly to a reviewer.