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Introducing the next phase of Sovica: the architecture for agentic care
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  • Templates
  • Claims and payments
  • Unpaid claim chase

Chase an unpaid claim before it goes quiet.

Thirty days after a claim goes out, check whether it’s been paid and give someone the follow-up.

Use templateWorkflows docs
TriggerClaim submittedDataA claim goes to the insurerDelayDelayWait 30 daysConditionConditionsClaim status is not PaidCreate taskActivitiesChase claim for {{first_name}}

Setup guide

Overview

A claim isn’t done when it’s sent. It’s done when it’s paid. This template rechecks each claim after 30 days and only creates work if it’s still open, so your team chases what’s outstanding and nothing else.

Prerequisites

These are the pieces we suggest having ready before you switch this workflow on. Your clinic may set things up differently, so treat the list as a guide.

  • A billing team member to own the chase

How to use this template

Once it opens, you’ll see the blocks joined up in order.

  1. The Claim submitted trigger is the first step. A run starts for each claim as it goes to the insurer, whether your team sends it by hand or Sovica raises it from the visit note. Each run follows one claim from then on. If you only want some insurers covered, choose them here, and leave the setting open for the rest.
  2. The Delay block waits for this insurer’s usual payment window, which is 30 days here.
  3. The Condition block reads the latest status, so a claim paid in the meantime stops here and nobody spends time on it. Add a rule for a smaller balance if you’d rather write those off, and anything left over carries on to your team:
    {Claim status} [is not] "Paid"
  4. The Create task block gives billing the chase. Set a name, a due date, the linked claim and a person responsible, and add the insurer’s reference to the description, so they have it to hand for the call.

Workflows FAQ