from submission
to reconciliation
Every EOB posted before you open.
PearlFlow collects remittances from all your payers overnight, posts each payment into your PMS, attaches the EOB to the claim, and leaves a short list of the claims that need a person.
- Delta Dental 3 EFTs fetched41 claims
- Availity 2 EFTs fetched12 claims
- MetLife 1 EFT fetched4 claims
- Matched to open claims in your PMS56 / 57
- Posted to patient ledgers EOB attached to each claim54 claims
- Finished before the 1:00 AM PMS shutdowndone
DeniedD4341, frequency limit · Delta
MismatchEFT short $38.00 · Availity
Not foundNo open claim for DOS 09/12
Sample receipt. Figures are illustrative.
Your front desk goes home. The posting starts.
Every night PearlFlow handles your insurance payments from start to finish, and your team arrives to a finished ledger.
- 1
Fetch remittances from all payers
- 2
Match to claims
- 3
Post to your PMS
- 4
Attach EOBs
- 5
Send the summary
Open one email. Work three claims.
The summary lists every exception with its reason, so your team starts on the work that needs judgment instead of keying payments.
| Patient | Reason | Carrier | Amount |
|---|---|---|---|
| M. Alvarez | Denied D4341 frequency | Delta | $0.00 |
| J. Okafor | Mismatch EFT short | Availity | $38.00 |
| R. Chen | Not found DOS 09/12 | Delta | $212.00 |
- Denied
Every procedure line paid $0. Posted with the denial reason so it can be appealed or written off.
- Partially paid
Some lines paid, some did not. Posted as paid, with the unpaid lines listed.
- Mismatch
The claims on an EFT do not add up to the deposit. Nothing on that EFT posts until it reconciles.
- Not found
The patient exists but no open claim matches the date and amount.
- Posted
Payment entered, EOB attached, claim closed in your system.
A claim is filed today and paid in three weeks. PearlFlow follows it the whole way.
Each claim carries a status from submission to reconciliation. A clinic-specific dashboard will show where every dollar is.
Paid is not billed
Your fee and the plan's allowed amount differ. PearlFlow records billed, allowed, paid and patient portion separately for each line.
Resubmissions stay linked
A corrected claim is tied to the original, so a payment on either one closes the chain once.
Your rules, per practice
When a line counts as denied or partially paid follows the policy your office already uses.
The same payment often shows up twice. It posts once.
Payers publish one remittance on more than one portal, and a denial is sometimes followed by a payment. PearlFlow checks before it posts and before it counts.
One EFT, two portals
A Delta EFT that also appears in Availity is posted once.
Denials that were paid later
If a claim has a paid sibling, its earlier denial is closed and left out of your denial totals.
Works with the software you already have.
No new practice management system and no change to your clearinghouse.
Practice management
- Eaglesoft
- Open Dental
- Dentrix
Payers
We work with all payers.
Built to the HIPAA Security Rule.
PearlFlow handles patient information as a business associate of your practice. The Security Rule groups its safeguards into three kinds. This is how we meet each one.
Administrative §164.308
- Business Associate Agreement
We sign a BAA with your practice before any patient data is shared.
- Minimum necessary
Operational alerts to our team have patient identifiers removed.
Physical §164.310
- HIPAA-eligible hosting
Patient data is stored and processed only on Amazon Web Services HIPAA-eligible services, covered by AWS's own BAA.
- No public exposure
Storage holding patient data cannot be made public.
Technical §164.312
- Encryption at rest
EOBs and claim records are encrypted at rest. Stored EOBs use dedicated keys that rotate automatically.
- Encryption in transit
Every connection uses TLS. Unencrypted connections are refused.
- Access control
Each person has their own sign-in, and each practice sees only its own records.
- Audit controls
Changes to patient records and access to stored documents are logged. Audit logs are kept for seven years.
- Integrity
Audit logs are tamper-evident, and every posting stays linked to the EOB it came from.
See a night run on your own payers.
Tell us which software and portals you use. We'll walk through a real run with you in thirty minutes.