Give patients the real amount before the visit, not an eligibility estimate.
Starview combines AI payer verification, patient authorization, and post-claim reconciliation. When portal data is incomplete, it calls the payer and returns the answer to the same case record.
Compare the result with your current process.
Before the visit
The patient knows the amount, why they owe it, and what happens if it changes.
Starview sends a cost briefing before the encounter. The patient can review the amount, ask questions, and authorize it before arrival. The practice keeps the calculation and payer evidence behind every line.
Service
[CPT / visit type]
Plan
[Plan name]
Your amount
[$1,776]
Why
Your plan confirmed that this service applies [$1,150] to your remaining deductible, then 20% coinsurance.
I reviewed this amount and authorize payment up to [$1,776] before the visit.
Questions can be answered before authorization. Access to care is not determined by this authorization.
Portal response
[Timestamp required]
Allowed-amount source
[Source required]
Payer call
As needed
Reference + recording
[If called]
Example authorization and evidence file. Bracketed values are placeholders.
Cash timing
The authorized amount can be collected before the encounter.
Visit commitment
Patients who authorize in advance are more likely to show up.
Payer documentation“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 staff collect less
Under-asking is rational when the cost of being wrong is one-sided.
Collect too little and the balance moves to AR. Collect too much and you create a refund, a credit balance, and a patient complaint. Staff protect the practice by asking for less.
The math behind the estimate
The amount changes with claims in flight, allowed amounts, and plan terms.
A 271 response reports accumulator values at the time of inquiry. It may not include claims that are still processing, so the remaining deductible can be overstated.
Coinsurance uses the allowed amount, not the billed charge. The calculation needs the contracted rate for the service and plan.
That is not a discipline problem. It is a math problem. Your team is choosing the smaller operational risk when the source data is incomplete.
Deductibles reset on January 1, plans change, and patients switch coverage. Q1 is often when you collect the most patient responsibility and when the available numbers move the fastest.
The response can be correct at the time of inquiry and still miss a claim in flight.
When the portal stops
Starview makes the call and returns the answer to the workflow.
The case record includes the deductible, coinsurance, allowed amount, benefit terms, payer reference, and source records required for staff to use the number.
What if the amount changes?
If the claim comes back different, Starview closes the balance.
A verified amount can still change after adjudication. Starview refunds an overpayment to the original payment method or collects the remaining balance with consent on record, so staff do not have to reopen the calculation at the front desk.
Verify
Collect
Adjudicate
Refund or residual
If the patient overpaid
Refund the original payment method.
Starview tracks the credit balance and sends the refund within the configured workflow.
If the patient still owes
Collect the residual with consent on record.
The payment request includes the amount, explanation, and source records from the case.
Compare one case with your current verification and collection process.
Review one case
Arrival
The patient checks in. The money conversation is already done.
The patient received the amount, explanation, and authorization request before leaving home. The coordinator sees an authorized amount and does not have to ask, negotiate, or defend an estimate at check-in.
What changes
One case. Four clear roles.
Patient
Reviews the amount, asks questions, authorizes payment, and confirms the visit before arrival.
Starview
Verifies the amount, explains it, records authorization, and reconciles after adjudication.
Coordinator
Confirms check-in. No payment conversation is required unless the patient asks for help.
Practice system
Receives the amount, authorization status, and case status through the agreed workflow.
Setup defines the operating boundaries.
We map payer coverage, practice-system connection, Medicare handling, authorization language, error responsibility, and refund timing before cases go live.
Product details
Responsibility, payer rules, pricing, and implementation.
How does the patient authorize the amount?+
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.
What if the patient does not authorize?+
The practice follows its existing policy. Starview records the status and keeps the explanation available, but it does not decide whether care proceeds.
If the amount is wrong, who is responsible?+
The service agreement defines responsibility before launch. A difference can come from changed payer data, a practice input, or a Starview calculation error, and those cases are not treated as the same thing. Regardless of cause, any patient overpayment is reconciled to the original payment method.
What if the final amount changes?+
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.
Do payers permit AI verification calls?+
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.
How is Starview priced?+
Pricing is scoped after a case review based on case volume, payer mix, practice-system work, and the authorization and reconciliation workflow. The first step is a small case set so the practice can compare the output before expanding.
How do you handle Medicare patients?+
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.
How does implementation start?+
Start with a small case set. Starview verifies each case, prepares the patient briefing, and records the result so your team can compare it with the current process before expanding the rollout.
Case review
See what the patient could know and authorize before the visit.
Bring one case. We will verify the available payer data, prepare the patient cost briefing, and compare it with what your current process communicates before arrival.
Chris Chen co-founded Trapeze, a Y Combinator company that brought voice AI to hundreds of specialty clinics. Starview applies that operating experience to patient-responsibility verification and communication.
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