Insurance & Claims

Bill insurance only where it’s worth it.

Most optimization clinics are cash-pay, and should stay that way. But some visits are genuinely billable — and a few practices run a real insurance line alongside the cash one. When you do, it should work properly.

Real-time eligibilityClaims submissionERA postingReadiness checklist
app.aminova.health · Checking Patient Eligibility
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Checking coverage, then filing a claim

Eligibility to remittance, without a separate portal.

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1

Cash-pay first, insurance where it earns its keep

A GLP-1 program billed to insurance is usually more administrative work than the reimbursement justifies. A consult, a lab draw or an office visit sometimes isn’t. Aminova is built cash-first and treats insurance as something you switch on for the parts of your practice where it pays — not an assumption baked into every screen.

2

Find out before the visit, not after

Real-time eligibility checks against the payer return coverage, plan status and patient responsibility before the appointment. That’s the difference between collecting at the desk and chasing a balance for three months.

3

Enrollment is the actual work, so we show it

Billing a payer electronically means enrolling with that payer, and enrollment takes weeks and paperwork. Rather than pretend otherwise, Aminova shows a readiness checklist — billing identity, clearinghouse connection, live payer enrollments, patients with insurance on file — so you know exactly what still stands between you and a submitted claim.

Eligibility

Coverage checked in seconds.

A real-time check against the payer returns whether the plan is active, what it covers and what the patient owes — run before the visit rather than discovered afterwards.

  • Real-time coverage check against the payer
  • Plan status, copay, deductible and remaining responsibility
  • Run ahead of the appointment or at check-in
  • The result is stored on the patient, not re-run every time

Eligibility — Dana K.

Coverage Active
Plan PPO — In Network
Copay $40
Deductible Remaining $620

Checked in real time before the visit, not guessed at the desk.

Claims

Filed from the encounter, not retyped.

The claim is built from the visit you already documented, with the payer’s routing resolved automatically. Submitting twice is prevented rather than discouraged — a duplicate claim to a payer is a compliance problem, not an inconvenience.

  • Built from the encounter — no re-entry into a portal
  • Payer routing resolved from a live payer directory
  • Duplicate submission blocked, not just warned about
  • Status tracked from submitted through to paid

Claim — #4471

Built From Encounter Mar 14 Visit
Payer Routing Resolved
Submitted Accepted
Duplicate Guard Active

A second submission of the same encounter is refused.

Remittance

See what actually paid.

Electronic remittances come back and post against the claim, so the gap between billed and paid is visible instead of being reconstructed from a paper statement weeks later.

  • Remittances ingest against their originating claim
  • Billed, allowed, paid and patient responsibility side by side
  • Denials surface for work rather than sitting unnoticed
  • Each clinic has its own ingest credential, never a shared key

Remittance — Posted

Billed $310
Allowed $186
Paid By Payer $146
Patient Responsibility $40

Posted automatically against claim #4471.

Readiness

Exactly what’s left before you can bill.

Clinics are usually told insurance billing is "set up" long before it can actually be used. The readiness checklist is deliberately blunt about what is done and what is not.

  • Billing identity — NPI and Tax ID on file
  • Clearinghouse connection configured
  • At least one payer enrollment live
  • How many of your patients have insurance on file at all

Billing Readiness

Billing Identity Complete
Clearinghouse Connected Complete
Payer Enrollments Live 2 Of 5 Pending
Patients With Insurance 38

You cannot bill a payer you have not finished enrolling with.

How it works

Three moves, one platform.

1 Check

Run a real-time eligibility check before the visit, so nobody finds out at the desk that the plan lapsed.

2 File

Submit the claim from the encounter, with the payer routing resolved for you.

3 Post

Remittances come back and post against the claim, so you can see what actually paid.

The insurance side, if you want it.

Your brand, one login, no stitched-together stack.

Real-time eligibility

Coverage, copay and deductible before the visit.

Claims from the encounter

Built from what you documented, not retyped.

Duplicate protection

The same encounter cannot be billed twice.

Remittance posting

Billed, allowed and paid, side by side.

Denial visibility

Denials surface as work, not as silence.

Payer directory

Resolve a payer name to its real routing id.

Enrollment tracking

Which payers are live and which are pending.

Per-clinic credentials

Your ingest token is yours, never a shared key.

Superbills instead

Or skip claims entirely and let patients file.

Questions

Should our clinic bill insurance at all?

Often, no. For most peptide, TRT and GLP-1 practices the reimbursement doesn’t justify the administrative load, and cash-pay with a superbill is the better business. Where it tends to be worth it is consults, labs and office visits in a practice that already has an insurance line. We would rather talk you out of it than sell you a module you’ll resent.

How long does it take to start billing?

Longer than anyone wants, and the delay isn’t us — it’s payer enrollment, which runs on the payers’ timelines and is measured in weeks. The readiness checklist shows exactly which enrollments are live and which are still pending, so you’re never told it’s "ready" when it isn’t.

Can we do cash and insurance at once?

Yes, and most clinics that bill at all do exactly that — memberships and medication on cash, certain visits through insurance. The two run alongside each other rather than the system forcing one model.

Can we bill medication to insurance?

That is between you, the payer and the pharmacy, and it is rarely how these products get paid for in this space. Aminova’s medication billing is built around cash and the routing rules that keeps your processor happy. How billing routes →

What if a claim is denied?

It surfaces as work with the payer’s reason attached, rather than disappearing into a report nobody opens. Aminova shows you the denial; working it is still a human job, and any vendor claiming otherwise is overselling.

Do you charge per claim?

No. Insurance is part of the flat monthly platform fee. Your clearinghouse may have its own costs depending on volume, and we’ll be straight with you about those before you switch it on. See pricing →

See it in action.

A 15-minute walkthrough, configured for how your clinic runs.