Read eligibility
Get the first
benefits bill right
Mage checks draft fees against billable enrollment and signed rates so finance can review expected charges and source records in one workbook
Read signed fees
Read draft bill
Check counts
Calculate fees
Match charges
Flag exceptions
Prepare review
Check the first bill before it goes out
As a self-funded group goes live, reconcile billable employees and retirees to the signed agreement. Repeat the same checks as enrollment and fees change each month.
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 every difference in the draft bill
Recalculate administration fees by group, billing month, and covered class. Show the count and rate differences separately, even when they nearly cancel out.
Group 024 · JanuaryEligibility cutoff
January invoice184Billable employees
Next effective month2February starts
Eligibility export · EL-024 · v3
Count enrollment by month
Apply the contract’s cutoff and effective-date rules to approved eligibility files. Send conflicting or incomplete rows to the eligibility team for review.
Group 024 · JanuarySigned retiree fee
Draft fee$19.50Prior schedule
Signed January fee$21.00FS-024 · v2
−$1.50 × 36 retirees−$54
Apply signed rates by class
Match employee and retiree fees to the signed schedule in effect for that month. Route expired, missing, or overlapping rates to billing before approval.
Resolve fee discrepancies before you bill the sponsor
Route each
bill issue
Give implementation, eligibility, and finance one review list with the affected group, billing period, dollar difference, and owner.
Catch fee
errors early
See which lines underbill or overbill when the draft uses an outdated rate or counts someone in the wrong month.
Trace each
invoice line
Record which eligibility export, signed fee schedule version, and draft invoice support the billing review.
How Mage fits
Run billing checks where your data is approved
Scope a private cloud deployment with your security team for workflows subject to HIPAA. Agree on access, permitted data flows, safeguards, and any required business associate agreements before using protected health information.
Your systems
Eligibility files
Group, billable class and effective dates
Signed fee schedules
Contracted rates and effective versions
Draft invoices
Draft quantities, rates and charges by group
The workflow between your tools
- 1Match group, class, and month
- 2Apply approved billing rules
- 3Compare draft and expected fees
Prepared for finance
Expected fees
Administration charges by class and month
Invoice exceptions
Count and rate differences with a review owner
Source record
Eligibility, fee schedule, and draft references
Finance approves invoice release.
Give finance a first invoice review workbook
See expected fees, draft charges, and each difference by class. Finance gets plan-level totals and source references, with access to member details limited to authorized reviewers.
Explore all solutionsEligibility
Cutoff
Signed fees
Classes
Draft
Group 024 · JanuaryEligibility cutoff
January invoice184Billable employees
Next effective month2February starts
Eligibility export · EL-024 · v3
Group 024 · JanuarySigned retiree fee
Draft fee$19.50Prior schedule
Signed January fee$21.00FS-024 · v2
−$1.50 × 36 retirees−$54
Group 024 · JanuaryFirst invoice review workbook
For reviewDraft $4,143Expected $4,160Variance −$17
| Class | Billable | Signed rate | Expected | Draft |
|---|---|---|---|---|
| Employees | 184 | $18.50 | $3,404 | $3,441 |
| Retirees | 36 | $21.00 | $756 | $702 |
| Total | $4,160 | $4,143 | ||
Draft minus expected−$17
- February starts in draftEligibility reviews+$37
- Prior retiree rate in draftBilling reviews−$54
Learn
Who counts
Confirm billable classes and the agreed cutoff date.
Design
Set rules and access
Map signed rates, assign reviewers, and limit access.
Automate
Review before every bill
Reconcile the first invoice and each monthly draft.
Review your next first invoice with Mage
Tell us how enrollment, fee schedules, and billing come together at launch. Describe the process using fictional examples and keep member or claim details out of the form.