AI Medical Billing Service Product · Patent Pending

MICRA-BEV™

Medical Insurance Card Reader API
Benefit & Eligibility Verification

Stop spending 15–25 minutes per patient on manual verification. MICRA-BEV automates the entire pipeline — from insurance card image to structured benefit report — via real-time dual-clearinghouse EDI 270/271. All in under 60 seconds.

99.3%
Field Accuracy
<60s
Avg. Turnaround
25
Payer Sweep Max
9
Webhook Events
BENEFIT REPORT — CPT 90837 · TELEHEALTH AUTO_ACCEPT ✓
// GET /verify/vfy_8x9k2m/report
{
  "carrier": "UnitedHealthcare",
  "confidence": 0.973,
  "status": "AUTO_ACCEPT",
  "deductible_remaining": 625.00,
  "copay_per_session": 30.00,
  "coinsurance_pct": 20,
  "telehealth_parity": true,
  "session_limit": "Unlimited",
  "prior_auth_required": false,
  "bh_carveout": false,
  "patient_estimate": 30.00,
  "cob_detected": false
}

Sample JSON response · Real-time via EDI 271

Interactive Demo

Watch the Full Pipeline: Card to Report in 60 Seconds

Press play to see each stage of the MICRA-BEV pipeline animate step by step — from card upload to structured benefit report.

The Problem

Manual Benefit Verification is Costing You

Every practice that checks benefits by hand is losing staff time, making transcription errors, and exposing claims to denial. MICRA-BEV eliminates each of these failure points.

15–25 Minutes Per Patient

Staff call payer hotlines, log into 8+ payer portals, manually enter card data, and transcribe benefits — for every single patient. A 20-patient practice is burning a half-day of billing labor on verification alone.

No Structured Output

Verbal or handwritten benefit notes can't integrate with your EHR, billing system, or RCM workflow. Manual transcription errors create downstream claim denials that cost far more to fix than prevent.

The BH Carve-Out Problem

Behavioral health benefits are frequently managed by a separate administrator from the medical plan. Standard BEV tools query the primary payer and miss mental health coverage entirely — resulting in denied claims.

$5–12
Staff cost per manual verification
14.2%
Avg BH claim denial rate (APA 2025)
8+
Payer portals a typical practice manages
<2 min
MICRA-BEV average turnaround
Interactive Demo

The BH Carve-Out Problem — Solved

See how MICRA-BEV detects carve-out signals that standard tools miss — and auto-reroutes to the correct mental health administrator.

How It Works

Three Delivery Tiers. One Platform.

MICRA-BEV meets your workflow where it is — staff-driven batch processing, patient self-service via embedded widget, or fully automated via API integration.

TIER A — Staff Portal

Staff Dashboard

Your billing team works directly in a dedicated secure portal. Two operational modes cover any volume:

SINGLE-MICRA

One patient at a time. Upload front + back card image → AI extraction → confidence review if needed → EDI 270 submission → structured benefit report in under 60 seconds.

MULTI-MICRA

Batch upload multiple card images simultaneously. Real-time per-patient progress in the background queue. Bulk ZIP download of all PDF reports when complete. Checkbox multi-select for targeted downloads.

WORKFLOW — SINGLE-MICRA
1
Upload Card Images

Staff uploads front + back of insurance card. Works from desktop file picker or mobile camera — any browser, no app required.

2
AI OCR Extraction

Payer-specific trained models extract all 20+ fields from both sides of the card. Confidence score calculated per field and color-coded green / yellow / red.

3
Confidence-Gated Review

≥95% → AUTO_ACCEPT. 85–94% → STAFF_REVIEW (card image shown alongside pre-filled form). <85% → MANUAL_ENTRY (red flags, blank form). Staff approves from the review queue before EDI submission.

4
Dual-Clearinghouse EDI 270

Routes via Availity + CLAIM.MD to the correct payer EDI endpoint. BH carve-out detection automatically reroutes queries to the correct mental health administrator.

5
Structured Benefit Report

271 response parsed into: deductible, copay, coinsurance, session limits, prior auth flag, COB status, telehealth parity, patient cost estimate. Three PDFs auto-generated for EHR upload.

TIER B — iframe / JS SDK

White-Label Embedded Widget

Embed directly in your existing patient portal or intake system. Fully white-labeled with your practice logo and colors. Patients photograph their own card — staff never have to touch it.

EMBED CODE
<iframe
  src="https://app.psybilling.com/widget/{token}"
  allow="camera"
  width="100%"
  height="600"
  frameborder="0"
></iframe>

The allow="camera" attribute activates the device camera directly in the browser. CropperJS provides a 1.6:1 aspect guide with blur/glare detection and a retake prompt if quality fails.

PATIENT WIDGET FLOW
1
Patient Opens Intake Page

Widget appears embedded in your portal or intake form. Patient clicks to activate camera. No app, no download, no login required — works in any mobile or desktop browser.

2
Card Scan with Quality Check

Camera activates with a 1.6:1 card-shaped guide overlay. Blur and glare detection checks quality in real time. If quality fails, patient is prompted to retake before submission.

3
Subscriber Verification Flow

"Are you the primary policyholder?" — relationship, subscriber name, and DOB collected. "Do you have secondary insurance?" — COB data captured and flagged for dual-coverage processing.

4
Silent Escalation

If OCR confidence falls below threshold, the patient sees "Thank you! We'll verify your coverage shortly." The escalation routes to the staff review queue — completely invisible to the patient. No abandoned intake sessions.

5
"I Don't Have My Card"

Widget includes a card-not-present path. Patient enters name + DOB → Insurance Discovery sweep runs automatically. Staff sees results in dashboard when complete.

TIER C — SMS / Email Links

Patient Intake Links

Branded URLs sent via SMS or email. Patient opens on their phone, camera activates immediately. No iframe integration, no login, no app. The simplest path to card capture at scale.

BULK CAMPAIGN TOOL

Upload a CSV of patient names + contact info → MICRA-BEV sends branded intake links to each patient via SMS or email → Results aggregate in the staff dashboard as patients respond. The bulk_campaign_completed webhook fires when all responses are collected or timed out.

8 DOCUMENTED USE CASES
UC-1
Widget Follow-Up

Patient started the widget but didn't complete it. Send an intake link as a follow-up nudge.

UC-2
Pre-Appointment Reminder

"24 hours before your session, please scan your insurance card so we can verify your coverage."

UC-3
New Patient — No Scheduling System

Direct intake link for practices without a patient portal. No integration required.

UC-4
Telehealth Pre-Session

Capture card remotely before the video session starts. No in-office visit needed.

UC-5
Insurance Change Mid-Treatment

"We received notice your insurance changed — please rescan your card at your earliest convenience."

UC-6
Dependent / Family Member

Collect subscriber relationship and secondary card data for a dependent patient on a parent's plan.

UC-7
Bulk New-Practice Onboarding

Import a full patient panel CSV, send intake links simultaneously to all patients.

UC-8
Coverage Lapse Follow-Up

Triggered automatically by the reverification_lapse_detected webhook when coverage expires.

Interactive Demo

Explore the Three Tiers: Dashboard · Widget · API

Click each tier to see the step-by-step workflow — from staff-driven browser upload to fully automated REST API integration.

AI Extraction Engine

Every Field. Both Sides. 99.3% Accurate.

Custom-trained payer-specific computer vision models extract 20+ fields from both sides of any insurance card — including pharmacy routing codes and electronic payer IDs for direct EDI routing.

Front of Card
Back of Card
carrier_name
member_id
member_name
group_number
plan_type (HMO/PPO/EPO...)
plan_name
effective_date
copay_specialist
copay_primary
copay_emergency
claims_phone
provider_phone
member_services_phone
rx_bin
rx_pcn
rx_group
payer_id (EDI routing)
subscriber_relationship
subscriber_name / DOB
secondary_cob_detected
AUTO_ACCEPT
≥ 95%
No Staff Time Required

All fields confirmed. EDI 270 submitted immediately. Zero review time. Results in the staff dashboard within 60 seconds.

STAFF_REVIEW
85–95%
Flagged for Confirmation

Uncertain fields highlighted yellow. Staff sees card image side-by-side with pre-filled form and confirms or corrects. In the patient-facing widget, escalation is completely silent — patients never see a failure state.

MANUAL_ENTRY
< 85%
Human Entry Required

Red-flagged fields presented blank. Staff enters data from card image displayed alongside. EDI 270 does not auto-submit until staff approves from the review queue.

Insurance Discovery

No Card? No Problem.

Insurance Discovery is a card-not-present payer sweep built on the same dual-clearinghouse infrastructure. Enter a patient's name and date of birth — MICRA-BEV sweeps up to 25 payers in parallel and returns all active coverage hits within 90 seconds.

MINIMUM REQUIRED INPUT
first_namelast_namedate_of_birth
OPTIONAL — IMPROVES HIT RATE
zip_codegenderssn_last4
SWEEP DEPTH (configurable per tenant)
tenant_only · tenant_then_regional (default) · full_sweep
90s
Max timeout
25
Max payers
3
Sweep layers
THREE-LAYER SWEEP ARCHITECTURE
Layer 1 — Tenant Payers
Your Configured Payer Network

EDI 270 queries submitted in parallel to every payer in your tenant configuration. Checked first because hit rates are highest for payers the practice has already enrolled with.

Layer 2 — Regional Payers
Top 10–15 by Market Rank for Patient ZIP

If Layer 1 produces no active coverage hits, the sweep expands to the top regional payers for the patient's state and ZIP code — excluding those already checked in Layer 1.

Layer 3 — National Carriers
8–10 Major National Carriers

Final sweep catches patients on national plans not covered in Layers 1–2. Multiple active hits are flagged as potential COB — primacy determination surfaced in the benefit report.

Discovery is available in all three delivery tiers: dashboard "Manual Lookup," widget "I Don't Have My Card" path, intake links, and via POST /discover API. Card-not-present verifications are billed separately from card-present scans.
Interactive Demo

Insurance Discovery: Three-Layer Sweep in Action

Run a simulated discovery sweep and watch payers get queried across all three layers — with COB detection when dual coverage is found.

Benefit Extraction

BH-Specialized 271 Parsing

Standard 271 parsers miss the nuances of behavioral health billing. MICRA-BEV is purpose-built for BH — extracting session limits, telehealth parity status, prior auth indicators, and carve-out detection that generic RCM tools overlook entirely.

Deductible

Annual deductible, amount met, and remaining — parsed separately for Individual and Family buckets.

Copay & Coinsurance

Per-session copay and coinsurance percentage. Patient cost estimate auto-calculated against your contracted rate.

In-Office vs. Telehealth

Coverage type broken out for both delivery modes. Telehealth parity flag surfaced explicitly — critical for CPT 90837 billing accuracy.

Session Limits

BH-specialized parsing catches session-limit data in 271 responses — a field most standard parsers skip. Mental health parity benefits flagged when session limits are unlimited.

Prior Authorization Flag

PA-required indicator surfaces as a warning banner with the payer's auth phone number and portal URL. Prevents claim submission without required authorization.

COB / Dual Coverage

OI segments parsed for coordination of benefits. Multiple Discovery hits flagged as potential COB with primacy determination.

The BH Carve-Out Problem — Solved

Behavioral health benefits are frequently managed by a completely separate entity from the medical plan — Optum, Beacon Health Options, Magellan. Standard BEV tools query the primary payer and miss the mental health coverage entirely. MICRA-BEV's BH-specialized 271 parsing detects carve-out arrangements and automatically reroutes the EDI 270 query to the correct mental health administrator.

THREE PDF DELIVERABLES PER PATIENT
CARD PDF

Front + back card images, auto-enhanced for legibility. Tenant-branded filename template.

REPORT PDF

Formatted benefit summary — deductible, copay, coinsurance, patient estimate. Fully tenant-branded for patient communication.

COMBINED PDF

Benefit summary + card images in one document. Single upload to patient's EHR chart.

Interactive Demo

Explore Every Field in the Benefit Report

Step through each BH-specialized field — deductible, copay, telehealth parity, session limits, prior auth, and COB detection.

API & Integration

REST API. 9 Webhooks. Any EHR.

MICRA-BEV exposes a clean REST API with structured JSON responses, HMAC-SHA256 signed webhooks, and exponential backoff retry. Integrate with any EHR, billing system, or practice management platform.

9 Webhook Event Types
scan_complete
Card OCR complete. Confidence score and carrier detected.
verification_complete
271 received. Full benefits JSON + report PDF URL returned.
discovery_complete
Payer sweep finished. All active coverage hits returned.
escalation_created
Confidence below threshold. Item entered staff review queue.
intake_link_completed
Patient completed intake link flow. Card + subscriber data captured.
reverification_lapse_detected
Scheduled re-verification found coverage expired or changed.
prior_auth_detected
271 indicates prior authorization required for CPT billing.
cob_dual_coverage_detected
Multiple active coverage hits — potential COB situation.
bulk_campaign_completed
All patients in CSV campaign responded or timed out.
All webhooks signed with HMAC-SHA256. Retry policy: exponential backoff 30s → 2m → 10m → 1h → 4h. Auto-disabled after configurable consecutive failures (default: 10).
GET /verify/{verifyId}/report 200 OK
// Structured benefit report
{
  "verifyId": "vfy_8x9k2m",
  "status": "AUTO_ACCEPT",
  "confidence": 0.973,
  "benefits": {
    "deductible_remaining": 625.00,
    "copay_per_session": 30.00,
    "coinsurance_pct": 20,
    "session_limit": "Unlimited",
    "telehealth_parity": true,
    "prior_auth_required": false,
    "bh_carveout": false
  },
  "patient_estimate": 30.00,
  "report_pdf_url": "https://...",
  "combined_pdf_url": "https://..."
}
Scheduled Re-Verification Engine

A separate nightly/weekly cron layer runs on the same BEV infrastructure. Configure re-verification frequency per tenant. When coverage changes or lapses are detected, the reverification_lapse_detected webhook fires — triggering intake link outreach or staff alerts before the patient's next appointment.

Competitive Advantage

MICRA-BEV vs. Everything Else

Capability MICRA-BEV™ Payer Hotline Availity Portal Standard Clearinghouse BEV
Insurance Card OCR Custom payer models
Real-Time EDI 270/271 Dual clearinghouse Voice only Single Single
Dual Clearinghouse Failover Availity + CLAIM.MD
Patient Self-Service Intake Widget + intake links
Bulk Batch Processing Multi-MICRALimited
BH-Specialized 271 Parsing Session limits, carve-out
BH Carve-Out Detection Auto-rerouteManual
Insurance Discovery (No Card) 25-payer sweep
Confidence-Gated Review Queue 3-tier system
Scheduled Re-Verification Lapse alerts + webhooks
REST API + Webhooks 9 events, HMAC-signedLimitedEDI only
Patient Cost Estimate Per session, CPT-specific
White-Label Widget Full tenant branding
Staff Time Per Patient< 2 minutes15–25 minutes10–15 minutes5–10 minutes
Who It's For

Built for Behavioral Health at Every Scale

Outpatient Mental Health Practices

Solo to 20-provider practices using TherapyNotes, SimplePractice, Valant, or TheraNest. Spending 15–25 min per patient on manual BEV today.

  • Single-MICRA for daily intake
  • Widget embedded in patient portal
  • Multi-MICRA for panel re-verification
SUD Treatment Centers

High-volume admissions with complex payer mixes, frequent re-verification needs, and H-code billing. Every new admission requires verified coverage before services begin.

  • Bulk campaign intake at admission
  • Multi-MICRA batch processing
  • COB detection for dual coverage
Third-Party Billing & RCM

Multi-tenant architecture maps directly to billing companies managing multiple practices. One MICRA-BEV account with isolated tenant workspaces and audit trails per client.

  • Separate tenant slugs per practice
  • API integration into billing workflows
  • Per-organization audit trail
Telehealth Platforms

Remote-first practices have no front desk. The embedded widget and intake links were specifically designed for card capture without an in-person visit.

  • SMS intake link pre-session
  • Telehealth parity flag in BEV report
  • API integration for platform embed
Pricing

Simple, Usage-Based Pricing.

Card-present verifications (from card scan) and card-not-present Discovery sweeps are metered separately. No seat fees. No per-provider charges. Pay for what you use.

Starter
$99/mo
100 card-present verifications

  • Single-MICRA staff dashboard
  • Card PDF + Report PDF
  • Confidence review queue
  • Email support
  • Discovery: $0.50/sweep
  • Overage: $1.50/verification
Enterprise
$799/mo
2,000 card-present verifications

  • Everything in Professional
  • Intake links + bulk campaigns
  • Scheduled re-verification engine
  • Custom payer AI models
  • Multi-tenant (billing companies)
  • Dedicated support + SLA
  • Discovery: $0.20/sweep
  • Overage: $0.75/verification
Pay-Per-Use
$0/mo
No monthly minimum

  • Staff dashboard access
  • Single-MICRA only
  • Billed monthly in arrears
  • No commitment
  • Card-present: $2.00/verification
  • Discovery: $0.50/sweep
PlanCard-Present (OCR + BEV)Card-Not-Present (Discovery)Overage Rate
Starter$99/mo — 100 included$0.50/sweep$1.50/verification
Professional$299/mo — 500 included$0.35/sweep$1.00/verification
Enterprise$799/mo — 2,000 included$0.20/sweep$0.75/verification
Pay-Per-Use$2.00/verification, no minimum$0.50/sweep

All plans include BAA · HIPAA-compliant infrastructure · AES-256 at rest · TLS 1.3 in transit · Self-hosted inference — no cloud OCR fees. Meridian Billing RCM clients receive MICRA-BEV at no additional charge on their plan's verification allotment.

Ready to Automate Your Benefit Verification?

Request a live demo and we'll walk you through the full pipeline using your actual payer mix. No generic slides — real data from your clearinghouse enrollment.