Workflow Automation

Workflow Automation for Pre-Claim Review

Help revenue cycle teams reduce preventable denials, billing delays, and manual cleanup before orders reach claim submission.

SignalDX helps labs turn issue detection into action. When an order has missing data, coding risk, payer policy concerns, or provider correction needs, SignalDX can route the order to the right workflow so your team knows exactly what to do next.

The Problem

Detecting issues is only half the work. Disconnected tools and manual follow-up make it hard to keep orders moving.

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Who should
review it?

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Does the provider
need to be contacted?

β–€β—‡

Coding vs policy vs
documentation issue

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Should the order be
blocked from billing?

⟳

Has anyone
followed up?

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Is the order ready to
move downstream?

SignalDX turns issues into workflows

SignalDX helps your team automatically route orders based on issue type, risk level, status, and required action.

Instead of simply flagging a problem, SignalDX helps create the next step.

Example automation rules
β†’Missing ICD-10 β†’ provider correction queue
β†’CPT mismatch β†’ coding review
β†’Payer policy risk β†’ policy review
β†’Missing provider NPI β†’ intake cleanup
β†’Documentation gap β†’ follow-up task
β†’Clean order β†’ ready for billing handoff

What workflow automation can do

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Route orders

Automatically organize orders based on what needs attention.

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Create tasks

Create a task for the right team when SignalDX detects an issue.

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Trigger corrections

Start structured provider correction workflows when input is needed.

⏱

Escalate delays

Help supervisors identify work that is taking too long.

Route orders to the right queue

Automatically organize orders based on what needs attention.

!

Needs Review

  • Newly detected issues
  • Incomplete orders
  • Review required
β–²

High Risk

  • High-risk score
  • Potential denial risk
  • Urgent work queue
β™™

Awaiting Provider

  • Provider correction sent
  • Missing ICD-10
  • Documentation needed
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Coding Review

  • CPT mapping
  • Missing modifier
  • Invalid ICD-10
β—‡

Policy Review

  • Payer policy risk
  • Medical necessity
  • Prior auth indicator
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Ready for Billing

  • Issues resolved
  • Clean order
  • Downstream handoff

A smarter workflow from issue to resolution

1
!

Issue is detected

SignalDX identifies missing data, coding risk, policy risk, or documentation gaps.

2
βš™

Workflow rule is applied

The system determines what type of work is needed based on the issue.

3
β–¦

Order is routed

The order moves into the right queue for intake, coding, policy, provider correction, or billing readiness review.

4
β˜‘

Task is created

A clear action is assigned to the appropriate team or user.

5
β™™

Staff resolves the issue

Your team reviews, corrects, approves, or requests missing information.

6
β†’

Order moves forward

Once issues are resolved, the order is marked ready for downstream handoff.

Example automation rules

Trigger Automated action
Missing ICD-10 Create provider correction task
Invalid ICD-10 Route to diagnosis review
Non-specific ICD-10 Route to provider clarification
CPT mismatch Route to coding review
Missing modifier Create coding review task
Missing provider NPI Route to intake cleanup
Payer policy risk Route to policy review
Documentation gap Create documentation request task
High-risk score Add to High Risk queue
All blocking issues resolved Mark Ready for Billing

Create tasks from detected issues

β˜‘Review missing diagnosis
β˜‘Validate CPT mapping
β˜‘Confirm ordering provider
β˜‘Request clinical documentation
β˜‘Review payer policy risk
β˜‘Approve corrected order data
β˜‘Prepare order for export

Escalate delayed work

⏱Provider correction request has not been answered
⏱High-risk order is still unresolved
⏱Task has been open too long
⏱Order is blocked from billing
⏱Review queue is growing

Why teams use SignalDX workflow automation

β–¦

Less manual routing

Orders are automatically organized based on the work required.

⚑

Faster issue resolution

Staff can see what needs action, who owns it, and what status it is in.

β™™

Better team accountability

Tasks, queues, and statuses help teams avoid duplicate work and missed follow-ups.

βœ“

Cleaner billing handoffs

Orders can be held until required issues are resolved, then moved downstream with confidence.

β–₯

More operational visibility

Supervisors can see bottlenecks, aging tasks, unresolved issues, and work by queue.

Built for flexible lab workflows

Every lab works differently. SignalDX workflow automation can support different review models.

β–¦Centralized intake review
</>Separate coding review team
β—‡Separate payer policy review team
β™™Provider correction team
β˜‘Supervisor approval before billing handoff
⚠High-risk order escalation
βœ“Clean-order fast track

Turn issue detection into action

SignalDX helps your team move from β€œwe found a problem” to β€œwe know exactly what to do next.”

β–¦

Automated queues

β˜‘

Clear tasks

⚑

Faster resolution

βœ“

Cleaner orders

⟳

Smart follow-up

β–₯

Better visibility

βš™

Turn issue detection into action

Automated queues. Clear tasks. Faster resolution. Cleaner orders.

Schedule a Demo