Claims runs
Automated solutions for health benefits administrationHealth benefits administration
Mage connects claims, bank, and enrollment records and learns each plan’s rules to forecast funding, reconcile plan reports, and catch billing errors.
Forecast funding and reconcile payments
See what each sponsor needs to fund before the next claims run. Match deposits and payment batches to cleared bank activity.
Explore claims fundingYour business, built into every workflow
Payment run · Nov 12
BAT-112Medical claims ACH
$160KBAT-113Medical claims check run
$92KClaims due$252K
Additional sponsor funding$210K
- Available plan cash
- $42K
- Sponsor cutoff
- Nov 11, 3 pm PT
DEP-109 · $60K expected
Excluded until cleared
Excluded until cleared
See what each sponsor needs to fund before the next claims run
Compare scheduled claims payments with available plan cash. Use sponsor-specific funding deadlines and notice thresholds to flag large payments for finance review.
Plan cash bridgePLAN-014 · USD thousands · Paid basis
+$8KOct net movement
Opening cashOpen207
Funding receivedFunds+1,320
Claims paidClaims−1,248
Fees paidFees−64
Closing cashClose215
Explain the month’s cash movement
Trace the closing balance through sponsor funding, claims payments, and fees.
Group 024 · JanuaryDraft vs. expected fees
Fee classDraftExpectedDraft − expected
EmployeesFebruary starts in draft
$3,441$3,404+$37
RetireesPrior retiree rate in draft
$702$756−$54
Net draft variance−$17
Explain differences before the first bill
Separate enrollment and rate differences so finance can verify each charge.
Give finance time to act before the deadline
More time
to fund
See when each funding notice is due and track the days until payment.
Clearer close
balances
Track the amount and age of deposits and payments still open at close.
Fewer billing
surprises
Catch enrollment and rate differences before sending the first invoice.
Solutions for health benefits administration
Start with the finance work behind a claims run, a monthly close, or a new client launch.
Draft funding notice
- By Nov 11, 3 pm PT
- $210K
- Scheduled claims
- $252K
- Cleared plan cash
- $42K
Claims fundingFlag large claims and match payments to cleared bank activity.Explore claims funding
Net cash movement
Sep
+$31K
Oct
+$8K
Deposit held
$18K
Plan reportingCheck plan totals and trace claims, funding, and fees to source.Explore plan reporting
Enrollment count
+$37
Retiree rate
−$54
Draft vs. expected
2 exceptions
−$17
Enrollment & BillingCheck enrollment and contracted rates before each employer invoice.Explore first invoice validation
How Mage fits
Connect plan, banking, and billing records
Connect claims files, plan bank activity, and enrollment and rates to your existing reporting systems. For HIPAA workflows, review private cloud, safeguards, access, and any required agreements with your security team.
Your systems
Claims payment files
Scheduled and paid batches with payment references
Plan bank activity
Sponsor deposits, cleared debits and available plan cash
Enrollment and rates
Eligible counts, effective dates and client fee schedules
The workflow between your tools
- 1Match records by plan
- 2Apply approved finance rules
- 3Prepare outputs for review
Ready for review
Funding review
Amounts due, deadlines and unmatched payments
Plan financial report
Claims, funding, fees and source references
Invoice checks
Expected charges and billing exceptions
Finance keeps approval authority.
Prepare the next claims funding review
Start with one plan. Agree how to calculate the funding request, show what changed, and give finance the evidence to approve it before the payment deadline.
Explore all solutionsClaims batches
Sponsor deposits
Bank activityFunding cutoffs
Claims funding reviewPLAN-1042 · As of Nov 10
For reviewFunding due · Nov 11, 3 pm PT$210K
Prior batch open$8K
| Item | Amount | Basis |
|---|---|---|
| BAT-112 · Medical claims ACH | 160 | Approved |
| BAT-113 · Medical claims check run | 92 | Approved |
| Available plan cash | −42 | Cleared |
| Additional funding due | 210 | By cutoff |
| Pending deposit DEP-109 · Not cleared | 60 | Excluded |
Learn
Map the funding cycle
Map claim batches, deposits, bank files, and due dates.
Design
Agree on rules and access
Set funding rules and agree on private cloud and access.
Automate
Run the next review
Test with synthetic data and route exceptions to finance.
Tell us about your next claims funding cycle
Tell us which finance workflow you want to automate and what your security team requires. Describe the process without including member or claim details.