Payer operations for behavioral health
Get paid for the care you already delivered.
Prior authorizations, denial appeals, and benefits verification in one governed work queue. The system drafts and tracks the work; a named person on your team approves every submission.
See your own payer workflow in 20 minutes.
Demo: an after-hours call is answered, benefits are verified, and a structured intake record is assembled for morning review.
One record
Every inquiry becomes one governed case.
Phone, SMS, web forms and referrals enter one coordinated workflow with an owner, a deadline, and an amount at risk.
Phone
11:47 PM
“Do you take Anthem? It’s for my son.”
SMS
11:52 PM
Insurance card photos received
Web form
11:58 PM
Dana W. · residential interest
Live chat
6:40 AM
“What should we bring to the tour?”
Referral
7:30 AM
Same family, from a counselor
8:02 AM
Eligibility response attached
One admissions record
INQ-3121 · created 11:47 PM
The leak map
Revenue leaks at every unowned handoff.
Each stage below is where revenue quietly drops out of a manual process. Watch the workflow close the breaks.
Demand that reaches handoff
47%
More than half of high-intent demand quietly drops out of a manual front door.
100%
84%
70%
58%
51%
47%
Inquiry
Intake
Insurance
VOB
Scheduled
Handoff
Free operator tools
Measure your own payer workload before you change it.
Interactive tools and field-tested templates that work on your numbers. No email gate, nothing submitted.
The workflow
One case. Five completed steps.
Watch the same record move from answer to handoff.
Conversation
Inbound call · 11:47 PM
Approved response source: Admissions FAQ v12
Transfer to staff: available
Capture
Contact & consent · timestamped 11:49 PM
Program interest: Residential
Insurance card: received by secure link
Verify
Eligibility: Active
Deductible remaining: $420
Coinsurance: needs confirmation → staff review
Schedule
Assessment · Tomorrow · 10:15 AM
Reminders: T-24h, T-2h
Quiet hours respected
Handoff
Summary: 6 lines, source-linked
Open items: 1 (coinsurance)
Synced to admissions queue · priority 2
AI admissions agent
Complete the work before your team steps in.
Verification of benefits
Benefits verification your team can trace.
Every result includes its source, verification time, remaining uncertainty and next action.
Scheduling and follow-up
Keep every inquiry moving overnight.
Pricing
Pricing built around your payer workload.
Implementation is scoped after a workflow review. A paid pilot is available when you want proof before rollout.
Launch
From $2,500/month
- One site
- Governed case queue
- Prior authorization and VOB
- Denial appeal drafting
- Standard reporting
Growth
Most commonFrom $5,000/month
- Multiple sites
- Review and routing rules
- Integrations
- Advanced analytics
- Higher authorization volume
Enterprise
Custom
- Network-wide deployment
- SSO and custom security
- Credentialing workflows
- Dedicated implementation
FAQ
Direct answers for operators.
Does this replace our EHR?
No. Marsa Health coordinates the payer work that happens around the chart: prior authorizations, denial appeals, benefits verification, intake routing and credentialing. Structured records sync into the systems you already run.
Does the system make clinical decisions?
No. It prepares administrative work from approved sources and drafts payer documents. Clinical judgment, medical-necessity determinations and anything uncertain route to your staff, with the full context attached.
How does benefits verification work?
Insurance details are collected by secure link, checked against eligibility responses and payer portals, and consolidated into one record. Every value keeps its source, timestamp and confidence status.
What happens when the system is uncertain?
Uncertainty is routed, never smoothed over. Fields that cannot be confirmed are marked as needing confirmation and placed in a human review queue with a deadline. Nothing reaches a payer without a named human approving it.
Who approves what gets sent to a payer?
A named person on your team. Every packet, appeal and correction carries an approver and a timestamp, and nothing is submitted automatically.
Which behavioral-health systems can the platform integrate with?
We build against EHR and CRM, scheduling, phone and messaging, and eligibility sources. Named integrations are listed only once live and tested.
How long does implementation take?
A single-site pilot is typically configured in two to three weeks, including your payer mix, authorization requirements and review routing.
Is a business associate agreement available?
A BAA is part of the production deployment conversation. We can walk through the current agreement and security posture on a call.
How are substance-use treatment records handled?
Workflow design accounts for 42 CFR Part 2 sensitivity: consent flags, restricted fields and role-based access are part of the record model.
How is pricing calculated?
Pricing follows the operation: clinician count, monthly authorization and denial volume, and workflow scope. Not seats, not AI tokens.