How to Automate Brightree

Brightree carries each CPAP order through rental billing and resupply

At a home medical equipment company, a CPAP patient stays on the books for as long as they use the machine. The company takes the referral, collects the physician's paperwork, delivers and sets up the CPAP, bills a rental or a purchase, and then ships masks, cushions and tubing on a schedule.

Brightree is cloud-based billing and business management software for HME and DME providers, with products for pharmacy, home infusion, orthotics and prosthetics, and sleep therapy. Intake coordinators build the patient and the sales order in it, and the documentation team tracks CMNs and signed orders against that order. Dispatchers plan delivery and pickup routes in Brightree Mobile Delivery, where the driver's app files each completed delivery with the patient's signature, a timestamp and a geocode. The billing team works claims and patient balances in Brightree as well.

Missing signatures and pending authorizations hold orders in the warehouse

An order can sit on hold with the CPAP already on the shelf. The referral came in without the face-to-face notes, or the CMN is still unsigned at the physician's office. The documentation team calls or faxes that office again and notes the attempt on the order. Prior authorizations are harder to spot: the decision posts on the payer's website, and intake learns of it only by signing in there and looking.

Billing has its own pile. Each denied claim means reading the reason, checking the payer's portal and deciding between a corrected claim and an appeal. Rental equipment that should have come back is still in a patient's home, and patient balances age another month. On Monday the owner asks for last week's collections by payer and location, and somebody builds that from exports.

Resupply Connect and MyForms run on what Brightree already knows

Intelligent Document Automation reads incoming referral faxes and creates the patient record and the sales order in Brightree from what it extracts. MyForms then generates the forms that order needs, based on the HCPCS, payer and diagnosis codes on the sales order, and captures e-signatures on them.

Resupply Connect finds the patients due for new supplies and takes their orders by email, IVR, app or portal, checking the insurance on file as it goes. For the billing office, Brightree lists denial management and the tracking of expiring authorizations among its services, and the Revenue Cycle Worklist lays outstanding AR out as lists for billers to work. Brightree Reporting adds an Executive Dashboard of business trends and ad-hoc reports that export to PDF or Excel.

The worklist tells a biller which claims need attention, and the biller still signs in to each payer's portal to see what that payer has on file. A prior authorization requested on a payer's website gets its decision on that website.

Denials and authorizations arrive sorted before billing opens

Intake knows by morning which open prior authorizations the payers have approved, which are still pending or denied, and which expire this month, each status read from the payer's own portal. For orders still missing a CMN or face-to-face notes, the documentation team checks and sends a drafted request to each physician's office. A biller opens last night's rejected and denied claims in the denial sheet, grouped by payer and reason, the corrected-claim cases split from the appeals, each with a draft note to accept or change.

Dispatch builds the next pickup route in Mobile Delivery around the rentals that should have come back, and each patient on the route has a pickup message waiting for staff to approve. After a delivery, the clinical team has a setup check-in for that patient to approve before it goes out.

Last week's collections by payer, product category and location are in the owner's sheet by Monday, with the change from the week before at the top.

Payers, patients and physicians only hear from your staff

Checking one authorization means opening the sales order in Brightree, signing in to that payer's portal and finding the request, and intake repeats it for every open order. WebRun is an AI agent that works a real Chrome browser, signed in as you. Brightree's role-based access decides what the agent's Brightree user can open, and each payer portal gets its own login.

Corrected claims and appeals stay as notes in the denial sheet until a biller submits them. Dispatch approves each pickup message, the clinical team each setup check-in, and the documentation team each follow-up to a physician's office. With typing turned off, claims and sales orders in Brightree can be read but not altered.

The workflows below all start in Brightree and cover those jobs, plus resupply outreach and patient balances.