For CFOs and COOs at specialty practices that already collect upfront
Starview is patient-responsibility software for specialty practices. It verifies the real amount before the visit, explains it to the patient, gets authorization, and reconciles after adjudication.
HIPAA-compliant · EHR + PMS integrations
Eligibility estimate
$?,???Verified patient amount
[$1,776]Source · SV-0247 · payer call + allowed rateBefore the visit
The patient receives a Cost Briefing they can review and authorize. The practice keeps the Evidence File, calculation, and payer source behind every verified figure.
Your verified amount
[$1,776]Source · Derived from $1,150 deductible + $626 coinsuranceWhy
The plan confirmed [$1,150] toward the remaining deductible, then [20%] coinsurance.
Source · payer confirmation + plan terms
I reviewed this amount and authorize payment up to [$1,776] before the visit.
Questions can be answered first. Authorization does not determine access to care.
Portal response
Attached to case
Allowed amount
Contracted rate file
Payer call
Used when portal is incomplete
Reference + recording
Stored with the case
Demonstration record. Not patient data. Brackets identify derived figures with an evidence path.
Source limitation“Each out of state Blue plan decides which benefit details appear on Availity and may not provide robust information. It may be necessary to contact BlueCard by phone for more details about the plans with sparse information.”
Blue Cross Blue Shield of Kansas · Eligibility & Benefits Inquiry Quick Reference Card · Page 2
Why the portal answer is not enough
Portal data can miss claims in flight, the allowed amount, or plan detail. Collect too little and the balance moves to AR. Collect too much and you create a refund, a credit balance, and a patient complaint.
Today’s order
With Starview
Incomplete portal record
The 271 shows [$2,400] with no warning. A [$900] claim still in flight reduces the usable amount to [$1,500].
Starview Decision Record
[$1,500]Source · payer call + pending-claim reviewStarview calls the payer and closes the gaps the portal leaves open.
Coinsurance uses the allowed amount, not the billed charge. The calculation needs the contracted rate for the service and plan.
ISA*00* *00* *ZZ*SOURCE *ZZ*DESTINATION ~ GS*HS*SOURCE*DEST*YYYYMMDD*HHMM*1*X*005010X279A1 ~ EB*G*IND*30*****$? ~ DTP*291*D8*YYYYMMDD ~ MSG*PORTAL RESPONSE INCOMPLETE ~At arrival
The patient already reviewed the Cost Briefing and authorized the amount. The coordinator sees a prepared case and confirms check-in.
Verified amount
[$1,776]Source · Decision Record SV-0247Authorization
On file
Source · patient response
Cost Briefing
Delivered before visit
Coordinator action
Confirm check-in
One prepared handoff
Patient
Reviews the Cost Briefing, asks questions, and authorizes payment before arrival.
Starview
Verifies the amount, explains it, records authorization, and keeps the Decision Record open through adjudication.
Coordinator
Sees the authorization status and confirms check-in without opening a payment negotiation.
Practice system
Receives the verified amount, authorization status, and case status through the agreed workflow.
Setup defines the operating boundaries.
Before launch, we map payer coverage, practice-system connections, Medicare handling, authorization language, who corrects each type of error, and when refunds must be sent.
After adjudication
Starview compares the authorized amount with the remittance, sends any refund to the original payment method, and explains any remaining balance before requesting payment.
Refined case outcome · SV-0247
Authorized before visit
[$1,776]Source · patient authorizationAdjudicated responsibility
[$1,642]Source · 835 / SPR remittanceReason annotation · CO-B6
The reason code stays attached to the remittance record. Its payer glossary definition is reviewed before the patient-facing explanation is sent.
Verify
Authorize
Adjudicate
Refund or residual
Compare one case with your current verification and collection process.
Verify your first caseBefore the first case goes live
Starview sends the verified amount and a plain-language explanation before the visit. The patient can ask questions and authorize payment up to the displayed amount. Authorization is separate from access to care.
The practice follows its existing policy. Starview records the status and keeps the explanation available, but it does not decide whether care proceeds.
The patient never absorbs an overpayment. Starview owns the correction workflow: it refunds an overpayment to the original payment method or explains a remaining balance before collection. If Starview made the calculation error, Starview corrects the Case and the service agreement defines the commercial remedy. Changed payer data and incorrect practice inputs are handled separately.
Starview compares the authorized amount with the adjudicated claim. It refunds an overpayment to the original payment method or explains and collects a remaining balance with consent on record.
Payer rules vary. During setup, Starview maps which plans permit automated verification and which require a human or another approved channel. It does not use an automated call where the payer prohibits one.
Starview uses custom pricing for multi-site specialty groups, not single-provider practices. Scope depends on monthly case volume, payer mix, practice-system work, and the authorization and reconciliation workflow. Start with a small case set, then receive a written scope before expanding.
Starview handles patient data in accordance with HIPAA requirements and signs a Business Associate Agreement with customers. Access, data flow, and retention are defined during setup.
Starview integrates with existing EHR and practice-management workflows. During setup, we map the fields, status updates, and handoffs required for verification, authorization, and reconciliation.
Medicare assignment rules can limit pre-service collection of deductibles and coinsurance, so Medicare cases require a separate workflow based on the patient and service.
Start with a small case set. Starview verifies each case, prepares the Cost Briefing, and records the result so your team can compare it with the current process before expanding the rollout.
Case review · SV-NEW
We will verify the available payer data, prepare the Cost Briefing, and compare it with what your current process communicates before arrival.
Case input
One upcoming patient responsibility case
Source review
Portal response, plan terms, allowed-rate source
Output
Cost Briefing + Evidence File
System fit
Existing EHR + PMS workflows
Comparison
Current process against Starview result
Next step
Choose a time to verify your first case
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