ClaimScope
ClaimScope

Revenue Intelligence for Podiatry

Stop guessing where your billing is leaking money.

ClaimScope learns every payer's unwritten rules from your own claims history — catches them quietly cutting rates, verifies payments against their own EOBs, and scrubs your claims before submission. Built specifically for podiatry practices — works with your EHR.

No PHI required Setup in under 10 minutes Cancel anytime
EXAMPLE
Money left on the table
$401K/yr
Payer rules discovered
760
Verified recovery
$23K
Claims scrubbed pre-submission
214
Revenue over time
Built on insights from
AAPC-certified principlesAMA CPT codingCMS LCD complianceHIPAA-aware design

The problem

Insurance companies count on you not noticing.

Quiet rate cuts

Payers reduce what they pay for a code by a few dollars and never announce it. Across thousands of claims a year, one silent cut costs $10K+. No one catches it manually.

Unwritten rules

Every payer has patterns they never publish: combinations they bundle, modifiers they require, frequency windows they enforce. You learn them one denial at a time — expensively.

Underpayment below their own numbers

Sometimes payers pay less than the allowed amount on their own EOB. Money they admit they owe, written off because nobody reconciles line by line.

How it works

From claim data to action plan in 10 minutes

Step 1

Export two reports from your EHR

Charge List and Ledger List — 5 minutes, no PHI (identifiers are hashed in your browser before analysis). Optionally add your ERA/.rmt remittance files for EOB-level verification.

Works with exports from any EHR — optimized for Practice EHR (including .rmt remittance files). Generic CSV imports supported.

EXAMPLE
Upload claims data
Charge List.csv
Ledger List.csv
Patient identifiers hashed · 4,812 claims ready to analyze
Step 2

ClaimScope analyzes everything

28 leak-detection rules, 6 payer-rule engines, and EOB reconciliation — all computed from your own history, in your browser. No industry assumptions, no data sent to a server.

Typical practice: 500+ payer rules discovered.

EXAMPLE
Revenue Leak Analysis
Modifier
Missed modifier 50 — 11721
$24,300
Underpayment
Healthfirst E&M underpaid
$18,200
Denial
CO-50 unappealed denials
$11,400
Bundling
CO-97 bundling errors
$7,900
Step 3

Act, then prove it

Work the prioritized playbook, scrub claims before submission, and re-upload monthly to see verified recovery — dollars conservatively attributed to plays whose target metric actually moved.

Includes a downloadable Executive Brief for your billing team.

EXAMPLE
High impact+$24,300
Add modifier 50 to bilateral 11721 claims

47 claims billed without modifier 50. Re-bill with documentation supporting bilateral.

Confidence: HighEffort: Low
Review documentation for bilateral procedures
Resubmit 47 affected claims
Train coders on modifier 50 usage

What ClaimScope does

The intelligence layer your billing software doesn't have

01

Payer Rules Engine

Reverse-engineers each payer's actual behavior from your claims history: which code combinations they underpay, which modifiers change payment, their real fee schedule per code — no contract required.

Typical practice: 500+ rules discovered.

EXAMPLE
Discovered payer rules
11721AUTO
WITH modifier 50 avg $109 · WITHOUT $44
Based on 31 vs 1,304 claims · Healthfirst
99213 + 20550AUTO
Bundled without modifier 25 — paid $0 on 22 claims
United Healthcare · discovered pattern
11055AUTO
Denied when billed inside 60 days of prior 11055
Aetna · frequency window learned from denials
02

Payer Watchdog

Catches rate step-downs and gradual erosion with dates and annualized cost. Grades every payer A–F against peers on payment rate, denial rate, and days-to-pay.

EXAMPLE
Rate cut detected−$11.2K/yr
11721 · Healthfirst: $58 → $50 starting Sep
Detected across 187 claims · never announced
Payer scorecard
HealthfirstB
UnitedA-
AetnaD
03

Get Paid Playbook

Every finding becomes a play: which claims to pull, what to verify in the chart, the filing deadline, who does it, and the dollar impact. Ranked by payback.

EXAMPLE
High impact+$24,300
Add modifier 50 to bilateral 11721 claims

47 claims billed without modifier 50. Re-bill with documentation supporting bilateral.

Confidence: HighEffort: Low
Review documentation for bilateral procedures
Resubmit 47 affected claims
Train coders on modifier 50 usage
04

Claim Scrubber

Upload pending charges before submission. Every claim is checked against the discovered payer rules, podiatry LCD requirements, and your own custom rules — flags with specific edits before the money is lost. Every scrub enforces both the learned payer rules and your own custom rules.

EXAMPLE
Pre-submission scrub
214 scrubbed12 blockers31 warnings
Blocker11721 · Healthfirst
Missing modifier 50 — bilateral documented in chart
Add modifier 50 · discovered rule (avg +$65/claim)
Add your own rules — your biller's knowledge becomes software.
05

Your Rules + Learned Rules

ClaimScope learns billing rules from your own payment history — which modifiers each payer requires, which combinations they bundle, which frequency windows they enforce — and turns them into checks that run on every future claim. Add your own rules too: anything your biller knows becomes software in minutes, enforced before submission so the same revenue is never lost twice.

EXAMPLE
Rules library
+ Add rule
DISCOVEREDbased on 1,304 claims
Require modifier 50 · Payer A · CPT 20550
MY RULEadded by you
Prior auth required · Payer B · CPT 11750
DISCOVEREDlearned from 218 denials
Frequency limit ~61 days · Payer C · CPT 11721
06

EOB Verification (ERA)

Drop in your electronic remittance files and ClaimScope reconciles every line against the payer's own allowed amounts — surfacing claims where they paid less than they said they owed, plus a breakdown of every adjustment reason code by payer.

EXAMPLE
Paid below allowed$4,820
Across 46 claims · HIGH confidence
Allowed on payer's own EOB, underpaid in remittance
Adjustment reasons · Healthfirst
CO-45Charge exceeds fee schedule$18.4K
CO-253Sequestration reduction$2.1K
CO-59Multiple procedure$1.6K
07

Progress & Verified Recovery

Re-upload monthly. ClaimScope diffs everything: what improved, what payers changed since last month, and the verified dollars your completed plays actually recovered — conservatively attributed, never inflated.

EXAMPLE
Since last upload
Modifier capture3% → 31%Denial rate18% → 12%Days to pay (Aetna)42 → 38Healthfirst 11721−$8
Verified recovery to date
$23,140
Attributed only to plays whose target metric moved

Built for podiatry

Podiatry-specific intelligence, not a generic tool

Podiatry billing has unique complexity — class findings for routine foot care, Q-modifiers for at-risk patients, bilateral procedures across multiple codes, LCD requirements for nail debridement and wound care. Generic billing analytics tools don't know any of this. ClaimScope is built specifically around podiatry workflows and codes.

  • Detects missed modifier 50 on bilateral codes (20550, 64450, 11721, 11055–11057)
  • Flags routine foot care without Q7/Q8/Q9 modifiers
  • Tracks LCD compliance for nail debridement, wound care, and orthotics
  • Identifies class finding documentation gaps (Class B/C systemic conditions)
  • Surfaces frequency-based denials common in podiatry (CO-50)
  • Detects bundling errors specific to foot procedures (CO-97)
  • Learns each payer's frequency windows for routine foot care and flags rebookings inside them before submission
  • Reconciles EOB allowed amounts line-by-line — including sequestration and multiple-procedure reductions

Compare

How ClaimScope compares

Setup time
10 minutes
Podiatry-specific
Learns payer rules from your data
✓ Automated
Modifier gap detection
✓ Automated
Pre-submission scrubbing with your custom rules
EOB allowed-amount reconciliation
Verified recovery tracking
Payer-by-payer drill-down
✓ Full
Contract benchmarking
✓ Cross-payer
Specific action recommendations
✓ AI-generated
Executive PDF reports
✓ One click
Cost
$99–299/mo

Pricing

Simple plans that pay for themselves

Solo Practice

For solo podiatrists

$99/mo
Best for: Solo podiatrists handling their own billing or working with an outside biller
  • Single provider
  • Unlimited claim analysis
  • AI recommendations
  • Monthly Executive Brief
  • Email support
Most Popular

Practice

For multi-provider practices

$199/mo
Best for: Multi-provider practices with 2–5 podiatrists
  • Up to 5 providers
  • Everything in Solo
  • Multi-office support
  • Payer detail drill-downs
  • Priority support

Plus

For larger practices

$299/mo
Best for: Larger groups, multi-office practices, or practices with their own billing department
  • Up to 15 providers
  • Everything in Practice
  • Custom integrations roadmap
  • Quarterly strategy review
  • Dedicated success manager

All plans include a free analysis of your first 90 days of data. No commitment.

Have a billing service? Ask about partner pricing — claimscope.io/partners

About

Why we built ClaimScope

Most billing analytics tools were built for hospital systems or generic medical practices. They don't understand the specific revenue patterns of podiatry — class findings, bilateral procedures, frequency limits, modifier requirements. ClaimScope was built from the ground up using real Practice EHR data from a working podiatry practice. Every detection rule was validated against actual claims, not theoretical examples.

We're a small team focused entirely on making podiatry practices more profitable. If you have feedback, requests, or just want to talk billing — email hello@claimscope.io.

FAQ

Questions, answered

Free analysis

See your practice's revenue opportunity in 10 minutes

We'll reply within 24 hours with next steps. Or email hello@claimscope.io directly.

See your practice's hidden revenue in 10 minutes

Upload your data. Get a personalized analysis. Decide if it's worth your time. No commitment.

Or email hello@claimscope.io to schedule a 15-minute walkthrough.