How it works, pricing, and why the usual fixes don't fit.
The browser is already your integration layer.
You run an independent billing or RCM shop, and your team logs into 10 to 20 payer portals a day because that is where the work lives. For most of it, there is no API coming, so the clicks fall to people.
No API, and often none coming
Your payer and clearinghouse portals were never built to talk to anything. For regional plans, behavioral health carve-outs, workers' comp, and secondary claims, there is no usable electronic feed. Someone logs in and reads it by hand.
You think in cost per biller
Every portal task is somebody's minutes. The 2024 CAQH Index puts a claim status inquiry by phone at $13.80 and about 25 minutes of provider time, and still $5.24 through a portal. Multiply that by your daily volume and it is a full seat of pure clicking.
Nothing off the shelf fits your size
Enterprise RPA is priced for health systems. Zapier can't log into a portal. Offshore VAs put credentials and PHI in the wrong hands. This is not an Epic or Cerner integration project. You need someone who builds it and owns it.
The four workflows I start with.
Automation pays where the same portal steps repeat on every claim. Here are four of them. Your team knows every one by heart.
Eligibility & benefits verification
Pull eligibility and benefits from each payer portal before the visit, so your team stops checking members one at a time. This is where behavioral health carve-outs bite: the 271 comes back with nothing usable, so the real answer only lives in the portal. That is exactly the work software can read for you.
Claim status follow-up
Chase claim status across every payer without a biller sitting in a portal doing it one claim at a time. At $13.80 and about 25 minutes per phone inquiry (2024 CAQH Index), this is usually the cheapest workflow to justify and the first one to pay for itself.
Denial worklist follow-up
Work the denial worklist the day denials land, not weeks later when timely filing is already at risk. The automation reads each denial, routes it by reason, and tees up the corrected claim, so your team acts on denials instead of just triaging them.
ERA / EOB retrieval
Pull ERAs and EOBs out of the portal-only payers that never send you an 835, so nobody is downloading PDFs and keying remits line by line into your billing system.
The prior-authorization API mandate arriving in 2027 (CMS-0057-F) will standardize some of this at the big national plans. It does nothing for the long tail your team actually fights: regional plans, behavioral health carve-outs, workers' comp, and secondary claims. That is the work with no API coming, and the work I build around.
Why the usual fixes don't fit a billing company.
Every alternative fails on the same two facts: payer portals have no API, and someone has to maintain the workaround when they change. Here is how each one breaks.
Priced for health systems. A ~$50,000-a-year license is the entry ticket, then you need certified developers at $100,000+ a year to build it and a team to maintain it. 30 to 50% of RPA projects fail (EY). The right comparison is not my price against a license, it is my all-in service against license plus developers plus the maintenance nobody budgets for.
Built for apps that already have an API. They cannot log into a payer portal, clear an MFA prompt, or read a PDF remit. The moment the work lives behind a login, they are out of the picture.
You are sharing payer credentials and exposing PHI, then paying again through turnover, retraining, and error rates. Outsourced billing typically runs 6 to 10% of collections, and a single in-house biller seat is $45,000 to $55,000 a year loaded. The clicking never actually goes away.
A script someone wrote breaks the first time a portal changes its login or layout, fails silently, and there is no one whose job is to fix it. You find out when the denials pile up.
Impressive, and improving fast, but an agent that re-plans every click gets it right most of the time, not every time. Even the best scores on OSWorld, the standard benchmark for real computer tasks, still leave a meaningful share failed. A claim needs the same steps done the same way on every run, with an error you can see when it doesn't work.
I build it, I run it, and I fix it when the portal changes.
The reason every alternative fails is maintenance. A payer changes a login page and the automation stops. So maintenance is not an add-on here. It is the service.
I build it
I map the workflow with your team, build it, and launch it. It runs in a dedicated Azure environment that I operate, under a BAA. Credentials and sessions stay in my Azure Key Vault on dedicated service accounts, never on a staffer's laptop or in a shared spreadsheet.
I run it
It runs on a schedule, monitored, with retries when a step doesn't take the first time. Your billers get clean batches and flagged exceptions back, instead of a portal tab open all day.
I fix it when it breaks
When a portal changes and the automation stops, fixing it is included, not billed hourly. That upkeep is the whole point. A maintained service is worth far more than a script nobody owns.
One price, per workflow.
$1,000 a month per workflow.
Nothing until it's running.
No setup fee, no contract, cancel anytime.
Price changes apply only to new workflows, with 60 days' written notice.
A workflow is one repeating task, like claim status checks, across up to 5 payer portals and up to 2,000 runs a month (a run is one patient or claim lookup). Extra portals are $200 a month each, and runs past 2,000 are $100 per extra 500, billed after the month ends. Running means it is working your real claims on its schedule and your team has signed off that the output is right, or 14 days have passed since delivery without an issue raised. The first invoice comes after that, not before. A portal added later starts billing the same way, once it is running and signed off.
Free: I'll score your five biggest payer portals.
Send me your five highest-volume payer portals. Within two business days you get back a one-page scorecard: how each portal handles MFA and sessions, which of the four workflows are automatable on it today, which aren't, and where I'd start. No call required, no obligation. It's free, so you can judge the thinking before you pay for anything.
Or book 15 minutes and walk me through them: book a call
15 years building healthcare software. Now I point it at your portals.
Two production systems make the pattern concrete: one pushing data into 30 portals with no API, one pulling data out of platforms that hoard it. The same pattern your payer portals need.
1,000× publishing output, zero hand-keying
Hourly staff hand-keyed data into 30 portals that had no API. Every typo was a credibility problem, and every departure meant retraining someone on all 30. I built a cloud pipeline that logs into each site and publishes through the browser, with retries and zero-downtime deploys.
From manual googling to 47,000 facilities
Employees googled assisted-living facilities one at a time and guessed at emails. Impossible past a few hundred records. I built a pipeline that collects records from government sources, enriches each through Google APIs, and validates every email for deliverability. No human in the loop.
Security, HIPAA, and payer terms, handled out loud.
The reason most developers won't touch payer-portal work is the same reason it's valuable. Here is exactly what the automation does and doesn't do, where your data lives, and who carries which risk.
Read-only by default
Eligibility, claim status, and remit retrieval only read. Denial follow-up queues the corrected claim for your team. Nothing is submitted, appealed, or changed in a portal unless you approve that kind of action for that workflow, in writing, when we set it up. Every change after that goes in a change log you can see.
Throttled to a human pace
One session per login at a time, paced like a careful biller, inside the hours you set. No parallel hammering of a payer's site, and it backs off on its own when a portal slows down or pushes back.
MFA stays on
I never ask you to turn off MFA. Codes go to an inbox or phone number your company owns and can revoke at any time. If a portal needs a person to approve a login, the run pauses and asks instead of working around it.
Credentials and PHI, locked down
Runs in a dedicated Azure environment that I operate, under a BAA. Hosting is included in the price; you don't need an Azure subscription. Credentials live in my Azure Key Vault on dedicated service accounts, never on a laptop or in a spreadsheet. Each build touches only the data it needs, encrypted in transit and at rest. Logs record what ran, not patient detail.
A BAA, every time
I sign a business associate agreement with every client before the automation sees a single record. No exceptions, no "we'll paper it later." The contracting entity is MV Mortensen LLC.
Who carries the payer risk
The portal accounts are yours, so the account risk and the payer relationship stay yours, and I don't indemnify payer actions. What I do: review each portal's terms with you before building, and automate only where it's permitted or the payer has approved it. If a payer ever flags an account, I stop that workflow the same business day and you don't pay for it while it's down.
What I need from you, and what you get.
I handle the setup. You give me access. Here is the whole exchange, including how you leave.
What I need
- A dedicated login for each payer portal in scope, in your company's name, not a biller's personal account.
- Access to the inbox or phone number your company uses for MFA codes.
- A signed BAA.
- An hour or two of a biller's time to walk me through the workflow, and a quick review of the first results.
- Where the output should land: a shared folder, a spreadsheet, or your billing system's import.
What you get
- The workflow built, hosted, monitored, and fixed when a portal changes. No hourly bills.
- Runs in a dedicated Azure environment that I operate, under a BAA. Hosting is included in the price, and you don't need an Azure subscription.
- A plain-English run report: what was processed, what was flagged, what failed and why.
- Your data, output files, and logins stay yours, start to finish.
Let's find one workflow worth automating.
Fifteen minutes. Bring the portal task that eats the most biller time, and I'll tell you honestly whether automating it pays, before anyone commits to anything.
Nothing until it's running.
Primarily billing and RCM companies. I also take on portal work for title, escrow, and insurance back-office teams that live with the same no-API problem.