Get paid for
every visit.

SimpliBill brings more than a decade of revenue cycle experience to your practice.

Get started free Talk to sales

app.simplibill.io / dashboard

Prevention engine

Watching claims leave the door · live

◆ Live

CLM-88213 Aetna PPO

CPT 99214 + procedure, same DOS

1Submitted for review

!Missing modifier 25

✓Modifier auto-corrected

→Sent clean to payer

Submitted

Flagged

Corrected

Sent clean

Clean Claim Rate

↑ 6.1 vs prior

Denial Rate

↓ 3.4 vs prior

Days to Payment

↓ 5 days

Expected vs Paid

↑ 2.0

7 claims held · missing modifier 25

Rule: E/M + procedure same DOS

✓

$12,480 underpayment recovered

Variance engine · BCBS IL contract

One platform for the entire revenue cycle

Claim scrubbing

Claims submission

Remittance & posting

Denials

Patient billing

Expertise

Built on years of real billing experience

SimpliBill comes from a team that has run revenue cycle operations for healthcare organizations for more than a decade. We have worked with large practices and busy billing departments, and we have handled the full range of payers, claim types, and exceptions that come with them.

Proven at scale

We have supported organizations that process large volumes of claims every day, and our platform is built to keep that work moving reliably.

Real payer knowledge

We understand how payers review and pay claims, and we build that knowledge into the way SimpliBill prepares and submits your work.

A team behind the software

You get more than a tool. You get the experience of a billing operation that has spent years learning how to get claims paid.

Why SimpliBill

Built to get your practice paid

Cleaner claims, faster payments, and far less manual work for your billing team.

Fewer denials

We review every claim against payer rules and correct common errors before it is submitted, so more of your claims are paid the first time.

Faster payments

Clean claims move through faster and spend less time in accounts receivable, which means your practice sees its money sooner.

Less manual work

Your team no longer needs to log into several portals or enter the same information twice. SimpliBill handles the repetitive work for you.

The platform

Four engines. One prevention layer.

SimpliBill replaces your practice management system with an architecture built around a simple idea: the cheapest denial is the one that never happens.

◆ Rule engine

Hold before harm.

A governed, versioned, auditable rules layer that holds or releases claims based on your logic, your contracts, your payer mix. No more filing tickets with dev. Build a rule, test it, ship it.

rule.idR_048_EM_PROC

triggerE/M + CPT same DOS

requiremodifier 25

actionHOLD · reviewer queue

statusv2.1 · active

◆ Expected payment

Know what you're owed before the ERA lands.

Expected allowed, expected payment, expected patient responsibility, expected payment date. Computed at charge entry from CPT, modifier, POS, provider type, and your loaded contract rates.

CPT 99214 · BCBS PPO$168.42

modifier 25 · +11%$18.53

patient coinsurance$37.39

Expected payment$149.56

◆ ERA & variance

Catch the underpayment the same day.

835 ingestion, auto-post, and variance detection compare what the payer actually paid against what your contract says they owe. Underpayments auto-generate AR tasks. Overpayments flag for recovery.

payer.paid$131.20

expected$149.56

variance-12.3%

taskauto-created · AR queue

severityflag · contract team

◆ Full PM replacement

Patients, providers, credentialing, claims.

Demographics, insurance stacking, coordination of benefits, eligibility, credentialing lifecycle with license and CAQH tracking, 837P scrubbing, corrected claim workflows. A complete PM system, not a billing overlay.

license.statusactive · expires 09/2027

caqhattested 30d ago

pecosenrolled

eligibilityverified · real-time

claim.releasecleared for submission

App & portal

SimpliBill app & portal features.

Powering smarter, more efficient revenue cycle management. SimpliBill combines powerful technology with an intuitive cloud-based platform to help healthcare organizations streamline revenue cycle operations, improve visibility, and make better-informed decisions.

Secure, Cloud-Based Access

Access your revenue cycle data securely from anywhere, anytime. SimpliBill provides a reliable, cloud-based environment designed to keep your information accessible and protected.

Real-Time Dashboard

Get a clear, up-to-date view of your operations with real-time dashboards that put critical performance metrics and workflow activity at your fingertips.

Claims Management

Streamline the claims lifecycle with tools designed to improve claim visibility, identify issues, and help your team manage claims more efficiently.

Payment Management

Simplify payment tracking and management with centralized visibility into payments, transactions, and outstanding balances.

Analytics & Reporting

Turn your revenue cycle data into actionable insights. Access powerful analytics and customizable reports to monitor performance, identify trends, and support better business decisions.

Customizable Workflows

Configure workflows around the way your organization operates. SimpliBill helps teams standardize processes, improve accountability, and reduce unnecessary manual work.

Patient Engagement

Support a better patient experience with tools designed to improve communication, simplify interactions, and keep patients informed throughout the revenue cycle.

How it works

From contract signed to clean claim paid.

Every stage of the revenue lifecycle runs inside SimpliBill. No duct-taped spreadsheets. No manual handoffs between three disconnected tools.

Contract

Auto-creates tenant, loads SOPs, enables modules

Onboarding

Provider roster, credentialing, go-live gates

Eligibility

Real-time verification and insurance stacking

Prevention

Rule engine holds or releases at entry

Variance

ERA posting with expected-vs-paid detection

Reporting

KPI dashboards, AI clusters, payer insights

Intelligence, in context

AI where it earns its keep. Humans where judgment matters.

We didn't bolt on a chatbot. SimpliBill uses AI for narrow, high-value jobs — and pairs every recommendation with industry experts who've spent years inside the work.

Advisory, not autonomous.

SimpliBill's AI layer surfaces patterns your team can't see at scale: denial clusters that point to a payer policy change, underpayment trends on a specific CPT, TFL risk on claims aging toward a deadline. Then a human decides.

Every AI recommendation routes through a review workflow. Nothing auto-applies to a rule without approval. The machine proposes. Your billing team, and ours, disposes.

ModuleDenial clusteringGroups recurring denials by payer, CPT, and root cause
ModuleUnderpayment detectionCompares posted payments against expected across contracts
ModuleTFL risk predictionFlags claims aging toward timely filing limits
ModuleRule suggestionProposes new hold rules based on denial history
ModulePayer anomaly detectionSurfaces behavior changes across payers and plans

Ready to get paid faster

Talk to our team and we will show you how SimpliBill fits into the way your practice already works.