Sightline finds the claims stalled on coordination-of-benefits questions, asks the patient the one question only they can answer, and returns a resolved coverage record your team can bill against.
When a payer flags coordination of benefits, the claim stops until someone establishes which coverage is primary. The answer usually lives with the patient, and nobody has a good way to ask.
The remittance comes back with a COB denial or a request for other-coverage information, and the balance sits while the clock on timely filing keeps running.
Work queues fill with cases that need a patient phone call, a payer hold line, or both. Each one takes minutes your team does not have, so most never get worked.
Cases that age out become bad debt or adjustments, not because the coverage didn't exist, but because the question was never answered in time.
Start with one file. Sightline works from the remittance data you already have, so there is no integration project between you and the first recovered dollar.
Sightline reads your 835 remittance files, or the claim-level CSV and XLSX exports you already produce, and runs every claim through a detection rulebook written by revenue cycle operators. Each COB case comes out scored by confidence and prioritized by the dollars at stake.
The outreach engine contacts the patient with a plain-language question about their coverage, in the channel they actually answer. Every touch is logged, and responses route back to the case automatically.
Confirmed answers become resolved coverage records with a full audit trail, queued for rebill ahead of timely filing. What was a work-queue backlog becomes a measurable recovery number.
835 remittance files or the claim-level exports your clearinghouse already produces. Upload a file, get scored cases.
Detection rules written from revenue cycle experience, with every flag explained: which codes fired, why the case scored the way it did.
Confidence bands and dollar thresholds rank the queue so your team starts where the recovery is.
Plain language, the patient's channel, and respectful cadence. Outreach that resolves cases without burning goodwill.
A dashboard for working cases: filtering and sorting, case detail, response review, analytics and trends, and clean exports for your billing team.
Append-only audit logging, PHI redaction, role-based access, and encryption in transit and at rest.
Sightline is a product of Pelorus, an operator-led advisory and product firm. The people behind it have run patient access, billing and customer service inside some of the largest health systems in the country, and built Sightline to solve a problem they worked by hand.
Send a recent 835 or claim export and see your open COB cases scored, prioritized and ready for outreach.
