Built exclusively for optometry & ophthalmology

Your best biller spends 60 hours a month on data entry.
Clearvara does it in seconds.

Automated EOB posting, payment reconciliation, and the only medical-vs-vision payer routing engine built for eye care. Your team gets their time back — fewer denials, faster payments, full audit trail.

40-60 hours/month freed from manual posting
300+ adjustment codes translated to plain language
15-25% of denials caused by routing errors — eliminated

Every morning, same story

Your billing team prints remittances from payer portals, matches each line to a claim, keys in the payment, looks up the adjustment code, calculates the write-off, and moves on to the next one.

Forty to sixty hours a month — just on data entry. Your most skilled billers tied up on work a machine should do, while denials pile up, appeals miss deadlines, and AR ages past 90 days.

And when your best biller calls in sick? Everything stops.

Hours lost to manual posting

Printing EOBs, matching payments, keying amounts, looking up CARC/RARC codes — every single day.

Routing errors cause denials

Medical or vision? Wrong choice means a denial. 15-25% of eye care denials come from incorrect payer routing.

📈
Denials and AR fall behind

When posting takes all morning, there's no time left for denials, appeals, and follow-ups — the work that actually recovers revenue.

EOB posting. Automated. Accurate. Auditable.

Clearvara retrieves your ERAs, matches every payment to the right claim, translates every adjustment code into plain language, and posts automatically — with a full audit trail.

1

ERA retrieval & parsing

Electronic Remittance Advice files retrieved automatically. Payment amounts, adjustments, patient responsibility, and claim-level adjudication extracted and organized.

2

Automatic claim matching

Every ERA record matched to the original claim by claim ID, with intelligent fallback matching by patient name, date of service, CPT code, and billed amount.

3

CARC/RARC translation

300+ adjustment reason codes translated to plain billing language, with optometry-specific flagging. Your team understands why a payment was adjusted — instantly.

4

Configurable auto-posting

Global and per-payer toggles with 7 safety criteria. Auto-post clean Medicare ERAs while manually reviewing vision plan payments. You decide how much to automate.

5

One-click undo

Any auto-posted remittance can be reverted with one click. Undo rate is tracked so you can see exactly how accurate the system is — real confidence data.

6

Bank reconciliation

EFT trace numbers matched to deposits in real time. Every dollar accounted for. No more hunting through bank statements.

Exceptions surface — they never hide

Unmatched or ambiguous records go to an exception queue for human review instead of being silently skipped. Nothing falls through the cracks.

What changes on day one

40-60
hours/month

freed from manual data entry. Your billing team works denials, appeals, and AR follow-up instead.

Same-day
posting

Payments posted the day they arrive — not days later. Faster cash flow from day one.

100%
audit trail

Every amount traced to the source ERA line. Auto-posting success rate tracked as a KPI.

Fewer
posting errors

Measurable accuracy with undo rate tracking. Real confidence data, not promises.

What your team does with the time they get back

Once posting is automated, your billers have capacity to work the exceptions. Clearvara gives them a prioritized playbook.

Daily Work Queue

One screen. Everything that needs attention today. No more switching between tabs to find work.

  • 11 work categories, priority-ordered by revenue impact
  • Dollar totals per category — work the highest-value items first
  • Filing deadlines, rejected claims, denials, payments, AR follow-ups — all in one place
  • Click-through to the relevant claim, denial, or payment — no hunting

Claims Lifecycle

Track every claim from encounter through payment — with complete visibility at every step.

  • Intelligent claim creation with automatic payer routing and pre-submission scrubbing
  • Full lifecycle tracking: pending, submitted, accepted, rejected, denied, paid
  • Filterable list with search, status filters, date ranges, and routing segmentation
  • Batch submission with pre-flight validation
  • Automatic 277CA processing with plain-language rejection reasons

Denials Worklist

Every denied claim surfaces with its reason, filing deadline urgency, and suggested next step.

  • Denial cards with reason, deadline, last note, and follow-up date
  • Categories: modifier, authorization, coverage, duplicate, other
  • Summary metrics: total denied amount, unworked count, top reason
  • Routing mismatch detection — identifies denials caused by incorrect medical-vs-vision routing

Appeal Workflow

Guided appeal creation that turns a 45-minute task into a 5-minute task.

  • Auto-generated appeal letters from denial-category-specific templates
  • Guided fill-in questions filtered by denial category and CPT code
  • Payer-specific appeal deadlines computed automatically
  • Dashboard alerts when appeal deadlines are approaching

AR Aging Worklist

Every outstanding claim, organized by age, with a suggested next action.

  • Five aging buckets: 0-30, 31-60, 61-90, 91-120, 121+ days
  • Medical-vs-vision split for analysis by payer type
  • 8-rule priority chain suggests the next step for each claim
  • Filing deadline warnings for claims approaching payer-specific limits

Eligibility Verification

Check patient insurance eligibility for both medical and vision plans simultaneously — before the visit, not after the denial.

  • Dual eligibility in a single request (medical + vision)
  • Benefits in plain language: "$30 copay, $500 deductible ($210 remaining)"
  • Coverage warnings: inactive policy, out-of-network, benefit exhausted, prior auth required
  • Results feed directly into encounter benefit estimation

Pre-Submission Claim Scrubbing

A rules engine that catches errors before claims go out — not after they come back denied.

  • 9 scrub rules covering the most common denial causes in eye care
  • NCCI bundling edits, laterality validation, timely filing alerts
  • Hard gate: claims with scrub errors cannot be submitted

Reporting & Analytics

Eight pre-built reports covering the metrics that matter.

  • Monthly Financial Summary, AR Aging by Payer, Denial Trends, Collection Rate
  • Payer Performance, Routing Accuracy, Clean Claim Rate, Denial Resolution Time
  • Medical-vs-vision breakdowns in every relevant report
  • CSV export for all reports

Medical or vision? Clearvara knows.

Eye care billing is unlike any other specialty. Most patients carry both a medical plan and a vision plan. Every procedure must be routed to the correct payer — and incorrect routing is the #1 source of denials in optometry.

The problem with generic billing tools

Generic RCM platforms treat medical-vs-vision routing as a manual dropdown — the biller picks "medical" or "vision" for each claim. This requires deep tribal knowledge, constant lookups, and creates a single point of failure when your most experienced biller is out sick.

Automatic classification

Every procedure classified as medical or routine/vision based on ICD-10 diagnosis codes, CPT procedure codes, and clinical context. No manual selection.

Per-line-item routing

When a patient has dual coverage, each line item is routed independently. The comprehensive medical exam (92014) goes to Aetna. The routine refraction (92015) goes to VSP. Automatically.

Split-billing support

When an encounter spans both payers, Clearvara identifies the split, separates the charges, and guides the biller through submission to each payer.

Plain-language explanations

"Routed to medical: diagnosis H40.11 [primary open-angle glaucoma] is a medical condition, not a routine vision exam." Your team verifies the logic and learns the rules over time.

Modifier-25 detection

Automatically identifies when a significant, separately identifiable E/M service was performed alongside a routine procedure and recommends modifier -25 — one of the most commonly missed revenue opportunities in eye care.

Routing accuracy as a KPI

Medical-vs-vision routing accuracy is tracked on the dashboard. You always know how the system is performing — with real data, not claims.

A generic RCM vendor would need to rebuild their entire routing engine for one specialty. Clearvara was built for this specialty from day one.

Automation that earns your trust

Clearvara doesn't force automation. Every action starts in human-in-the-loop mode — the system recommends, you approve. Increase autonomy at your own pace.

You decide

Auto-post clean Medicare ERAs while manually reviewing vision plan payments

You decide

Route established-patient exams automatically while reviewing new-patient encounters

You decide

Enable automatic eligibility checks at scheduling while manually verifying complex cases

Accuracy tracked per task type

Auto-posting success rate, routing accuracy, scrub catch rate — all measured and visible. The system proactively suggests increasing autonomy when thresholds are consistently met, with clear evidence.

Dial back at any time

Switch to manual with zero data loss. This isn't a toggle between "manual" and "AI." It's a trust gradient that respects the expertise of billing professionals.

Every decision is explainable

Every routing decision, every scrub finding, every auto-posted payment — explained in plain billing language. Complete audit trail of every action with timestamp, actor, and rationale.

Today vs. Clearvara

Today (Manual) With Clearvara
Print EOBs from payer portals, manually key payments ERAs auto-retrieved and posted in seconds
Look up CARC/RARC codes in a PDF reference Adjustment codes translated to plain language inline
Check a spreadsheet to decide medical vs. vision Automatic routing with plain-language explanation
Call the payer to check eligibility Real-time dual eligibility check (medical + vision)
Track filing deadlines in a calendar Automatic alerts with escalating urgency
Switch between 5 screens to find today's work One prioritized work queue with dollar amounts
Spend 45 minutes drafting an appeal letter Auto-generated letter with guided fill-in questions
Run reports in Excel from exported data 8 pre-built reports with medical/vision breakdowns

Compliant. Secure. Auditable.

Built on HIPAA-eligible infrastructure from day one — not bolted on as an afterthought.

HIPAA-compliant architecture

Encryption at rest and in transit

Role-based access control

Minimum necessary principle enforced

Full audit logging

Every action logged for HIPAA audit readiness

Business Associate Agreements

All third-party services covered

No PHI in dashboards

Summary metrics never expose patient data

AWS HIPAA-eligible infrastructure

ECS Fargate, RDS, Cognito

Connects to your existing workflow

Clearinghouse

Electronic claim submission and ERA retrieval

Payer Enrollment

Automated enrollment for ERA, Claims, and Eligibility transactions

EHR Integration Roadmap

FHIR API integration with Compulink and RevolutionEHR

CSV Import/Export

Import patients and fee schedules; export reports and data

Ready to stop posting EOBs by hand?

See how Clearvara can give your billing team 40-60 hours a month back — with fewer denials, faster payments, and full visibility into every dollar.

Request a Demo

No commitment. We'll walk you through the platform with your payers and your workflows.