Auto-Generated Claims
Claims created automatically when session notes are completed. All billing codes, modifiers, and authorization references populated instantly.
The "Glass Box" Revenue Defense Engine
ABA Billing Software That Defends Every Dollar
Don't just outsource billing—gain clarity. VGPM shows you every claim, tracks every denial in real-time, and automates payment posting so you can make payroll with confidence. See the full revenue picture, from session to deposit.
95%+
Clean Claim Rate
Pre-submission validation catches errors before they become denials
50%
Faster Posting
Automated ERA processing eliminates manual payment entry
Real-Time
Denial Tracking
See denials the moment they happen, not weeks later
Claims Management
How Does ABA Billing Software Handle Claims?
VGPM automates the entire claims lifecycle—from session completion to payment posting—with real-time visibility at every step.
Session Complete
Note signed, ready to bill
Claim Generated
Auto-created with all data
Submitted
Sent to payer electronically
Accepted
Payer received, processing
Payment Posted
ERA processed, revenue recorded
Pre-Submission Validation
Authorization limits, provider credentials, and payer rules checked before submission. Catch problems before they become denials.
ERA Auto-Processing
Electronic remittance files parsed automatically. Payments posted, adjustments decoded with human-readable explanations and suggested next steps, patient responsibility calculated—no manual entry.
Bulk Operations
Submit, void, or resubmit multiple claims at once. Filter by date, payer, or status and act on hundreds of claims in seconds.
Claims List
2 Tags Active
97153$125
97155$85
97151$210
97153$125
Filter by Tag
Workflow Organization
Tag Claims Your Way, Find Them Instantly
System statuses tell you where a claim is. Tags tell you what to do next. Create custom labels for follow-ups, payer issues, priority work, or anything your workflow needs. Filter by tag to work through queues efficiently.
Multi-tagging supported Bulk tag operations Full audit history
Visual Organization
Color-coded tags with unique icons make problem claims instantly recognizable. No more hunting through spreadsheets.
Spot issues at a glanceSmart Filtering
Filter your claims list by any combination of tags. Work through your follow-up queue methodically every morning.
Work smarter, not harderWorkflow Queues
Create custom workflows: tag claims needing follow-up, filter daily, resolve, remove tag. Your denial management system.
Nothing falls through the cracksComplete Audit Trail
Every tag change is logged in the claim timeline. Know who tagged what and when for compliance and team accountability.
Full visibility for your teamYour Tags, Your Workflows
Create tags for anything: Follow Up Today, BCBS Auth Issue, High Dollar Priority. Tags are fully customizable, and every change is tracked in the claim's audit timeline.
Patient Invoicing
How Do I Bill Patients for Their Portion?
VGPM automatically generates patient invoices from insurance EOBs, tracks payments, and manages write-offs—recovering the 20-40% of revenue that comes from families.
1
ERA Processed
Insurance pays their portion, patient responsibility identified
2
Invoice Created
Patient invoice auto-generated with copay, coinsurance, or deductible
3
Reminders Sent
Automated emails notify families of balance due
4
Payment Received
Card, ACH, check, or online portal payment recorded and reconciled
Automatic Invoice Generation
Patient invoices created automatically from ERA data. No manual calculation of copays, coinsurance, or deductibles.
Multiple Payment Methods
Accept credit cards, ACH transfers, checks, and online portal payments via Stripe. Payment plans for larger balances. All tracked in one place.
Learn about Stripe IntegrationAutomated Reminders
Configurable reminder emails for unpaid invoices. Set timing, frequency, and tone. Stop chasing payments manually.
Write-Off Management
Track contractual adjustments, bad debt, and courtesy write-offs separately. Approval workflows prevent unauthorized write-offs.
Don't Leave Money on the Table
For many ABA practices, 20-40% of revenue comes directly from families—copays, coinsurance, and deductibles. VGPM ensures you capture every dollar with automated invoicing and persistent but professional follow-up. With VGPM's Stripe integration, families can pay invoices online through the client portal—making it easier to collect and faster to reconcile.
Claims Visibility
Where Is Every Insurance Dollar Right Now?
Your Claims List is your revenue command center. See every claim's status, filter to what matters, and track totals in real-time. No waiting for reports, no hidden queues—just transparent visibility into your practice's cash flow.
Claims List
3 Filters
Status: Ready
Last 30 Days
All Payers
Filtered Totals
Billed$127,450
Ins. Paid$98,320
Patient Resp.$12,840
Pending$16,290
Martinez, Sofia$1,240.00Ready
Chen, William$2,180.00Pending
Johnson, Aiden$890.00Reconciled
Filter to What Matters, See the Totals Instantly
Your Claims List defaults to showing problem claims—rejections, errors, and items needing review. Filter by status, payer, provider, or date range, and the totals panel updates in real-time. No separate reports to run.
Instant totals by any filter Default problem-claim view Export to CSV anytime
Real-Time AR Monitoring
Your Claims List totals panel shows billed, paid, pending, and patient responsibility amounts—updating instantly as you filter. No waiting for nightly reports.
- Billed, Ins. Paid, Patient Resp. at a glance
- Totals update as filters change
- Filter by payer to see performance
- Spot revenue trends immediately
Smart Claim Workflow
The default view shows claims needing attention: rejections, errors, and items in review. Work your problem queue first, then batch-submit ready claims.
- Default: Problem claims only
- Filter by 12 claim statuses
- Filter by payer, provider, code
- Bulk "Send All" ready claims
Export for Analysis & Reconciliation
Export filtered claims as CSV summaries or line-item detail. Analyze CPT code revenue, payer performance, or reconcile with your accounting system.
- Claims CSV: Summary per claim
- Claim Items CSV: Line-item detail
- Export respects active filters
- Perfect for month-end close
Transparency, Not Black Boxes
Every claim status is visible. Every filter is yours to control. See exactly what's billed, what's pending, what's paid, and what needs attention. No hidden queues, no mystery reports—just a glass box view of your revenue cycle.
"You didn't become a BCBA to chase insurance payments. VGPM's Revenue Defense Engine handles the billing complexity—from claim submission to denial recovery—so you can focus on clinical outcomes, not collections."
Frequently Asked Questions
When a session note is completed, VGPM automatically generates a claim item with all required data: billing codes, modifiers, units, dates, provider credentials, and authorization reference. Claims batch automatically based on your submission schedule and are sent electronically to payers. You see every claim's status in real-time—from pending to submitted to paid.
Denials are caught instantly when the ERA (Electronic Remittance Advice) is processed. VGPM categorizes each denial by reason code (CO-4, CO-16, CO-18, etc.) and shows you exactly what went wrong. Every adjustment code includes a plain-language explanation of what it means and a recommended next step—so your team knows immediately whether to appeal, rebill, or write off.
Yes. When an ERA shows a patient responsibility amount (copay, coinsurance, deductible), VGPM automatically generates a patient invoice. Families can pay via credit card, ACH, check, or online through the client portal using VGPM's Stripe integration. You can set up payment plans for larger balances. Automated reminder emails go out for unpaid invoices, and you control the timing and frequency.
The Claims List shows all claims with their current status, aging buckets (0-30, 31-60, 61-90, 90+ days), and expected payment amounts. Filter by payer, status, date range, or provider to find exactly what you need. The totals panel gives you real-time summaries of billed, pending, and collected amounts.
VGPM supports unlimited insurance payers with payer-specific billing rules. Each payer can have different submission formats, timely filing limits, and authorization requirements. The system tracks which clients have which payers and applies the correct rules automatically.
Multiple validation layers catch errors before they become denials. Authorization validation ensures you never bill beyond approved units. Credential checking confirms the rendering provider is credentialed with the payer. Date-of-service validation catches late submissions before timely filing limits expire. If something's wrong, you see a clear warning—not a denial 30 days later.
A clean claim is one that's accepted by the payer without needing corrections or resubmission. Industry average is around 80%. VGPM practices typically achieve 95%+ because the system validates claims before submission. Higher clean claim rates mean faster payment, less rework, and better cash flow.
VGPM tracks three types of write-offs: contractual adjustments (automatic from ERA), bad debt write-offs (uncollectable patient balances), and courtesy write-offs (hardship cases). Each requires appropriate approval and creates an audit trail. Write-off reports help you monitor trends and protect against revenue leakage.
Ready to Protect Your Revenue?
See how VGPM's billing automation can defend every dollar your practice earns. Watch our demo to see the "Glass Box" Revenue Defense Engine in action.