Medicaid Billing Software for Care Providers
Build claims from your authorizations, send them through Availity, and watch every payer response land on the right claim, without a clearinghouse login in another tab.
Every claim, from authorization to deposit
Medicaid billing for a small care business is rarely hard because of one claim. It is hard because of hundreds of them, each tied to a member, an authorization, a service code and a date, each answered by the payer in its own file format days later. A claim that was rejected on Tuesday and nobody noticed is a payment you will not see this month.
Zeumatic builds claims in the standard EDI 837 professional format straight from the records your team already keeps: the member, the plan, the authorized service and the days served. Claims go out one at a time, in a batch you review first, or through a weekly billing run that prepares them for you. Each one is sent to the payer through the Availity clearinghouse.
Then the part most billing tools leave to you: the answers. Availity's 999 acknowledgments, the plan's 277CA claim acknowledgments and the 835 electronic remittances are read automatically and matched to the claim they belong to. A rejection shows the payer's own reason next to the claim, so the fix is obvious, and a payment posts itself with the amount the plan actually paid.
Some payers still mail paper. For them, Zeumatic reads the scanned explanation of payment with AI, page by page, and posts it only when the lines add up to the check's total. For payers that send no remittance at all, a claim can be marked as denied by hand, with the reason, so nothing sits in limbo.
Works for
Every care business Zeumatic is set up for
The life of a claim in Zeumatic
- 1
Built from the record
Member, plan, authorization and service code come from the client's record. One claim line per served day, so a payer can pay or deny each day on its own.
- 2
Checked before it leaves
A day already billed cannot be billed twice (the database refuses it) and claim numbers stay within the length some plans cut off.
- 3
Sent through Availity
Claims leave as EDI 837 over Availity's secure file transfer, individually, in a batch, or on the weekly schedule you set.
- 4
Answered and reconciled
999, 277CA and 835 files come back and are matched automatically. Accepted, rejected, paid or partially paid: each claim always shows where it stands.
Works hand in hand with
Available today, and what is coming next.
Daily Checks
Each day, Zeumatic lists what blocks billing: a missing payer code, an expiring authorization, a rejected claim.
AI Document Reading
Authorization PDFs and paper remittances read by AI and pre-filled for your team to review. No retyping.
Automations
Billing runs and recurring jobs scheduled on the days and times you choose, or run them on demand.
Analytics
Billed versus received, payer by payer, claims and clients over any period, plus a full audit log.
CRM
Client records, coverage, authorizations and documents in one place, with alerts before an authorization expires.
Optimized Routes
Delivery routes optimized in the Spoke dispatch app and kept in sync with Zeumatic. The days actually delivered come back for billing.
“Every claim is tracked from submission to payment. I see what's paid, denied or still pending without calling the payer.”
Laura
Billing Manager, TLC Nursing Registry
Questions we hear
Does Zeumatic bill Medicare as well as Medicaid?
Yes. Claims are standard EDI 837 professional claims sent through Availity, so Medicare and Medicaid managed care plans that receive claims there are billed the same way.
Do we need our own Availity account?
Your company is enrolled with each payer under its own NPI and tax ID. Zeumatic sends and receives the files through Availity for you and routes each response back to your company.
What does a rejected claim look like in Zeumatic?
It is flagged on the claims list with the payer's reason, taken from the acknowledgment file. Fix the record, resubmit, and the claim's history keeps both attempts.
Can we bill private-pay clients from the same place?
Yes. Clients who pay out of pocket receive invoices, next to the claims your plans pay electronically.
Can someone check a batch before it is sent?
Yes. A batch is prepared first and shown with the days it covers and anything already billed, so a biller approves it before a single claim leaves.
Ready to Transform Your Operations?
Bring your clients, claims, payments and routes into one place. Book a demo, or start your free trial today.