Cross-site patient responsibility for dermatology groups on ModMed

Every patient balance across sixteen sites, and a write-off you can defend.

Clearside reads your ModMed ledger and puts every patient’s responsibility — every site, every encounter — on one page. Then it holds each write-off to a standard you would be willing to show an auditor.

Reads from ModMed. Writes back nothing.

0–30 days$15,133
12% of the open balance · 32 accounts
31–60 days$19,368
16% of the open balance · 47 accounts
61–90 days$22,279
18% of the open balance · 49 accounts
91–120 days$20,681
17% of the open balance · 49 accounts
120+ days$46,001
37% of the open balance · 105 accounts
Open balance by age across all sixteen locations, measured from the patient-responsibility date. $46,001 of it is already past 120 days — more than a third, sitting in 105 accounts.
open across 282 accounts
$123,446
open across 282 accounts
collection rate on patient responsibility
42.4%
collection rate on patient responsibility
awaiting a write-off decision · $81,978
215
awaiting a write-off decision · $81,978
follow-ups already past their date
65
follow-ups already past their date

Figures from the demo dataset — 256 patients, 320 encounter accounts, 16 locations. Entirely synthetic; no real patient appears anywhere in this application.

Three things a practice-management system will not tell you

None of this is a failure of ModMed. It is a ledger, and it answers ledger questions. These are the questions a revenue manager asks instead.

The balance lives wherever the visit happened

A patient seen at three of your sites has three ledgers, and no page in ModMed adds them up. The front desk quotes one number, the statement shows another, and the practice has no single figure for what patients owe.

The third statement goes out, and then the account stalls

Someone decides to write it off or chase it, usually from memory and usually at the end of a long day. The reasoning is not written down anywhere, so it cannot be reviewed, repeated, or defended six months later.

Age is the number nobody is watching

Balances are read as a total, not as a distribution. By the time a practice notices that a third of what it is owed is past 120 days, the money that could have been collected has usually gone.

What Clearside does

Nine things, all of them built and all of them visible in the demo. Anything not listed here is not built — see the limits below.

One balance across every site

Responsibility, paid, adjustments and open balance for all sixteen locations. Change the location in the header and every figure on the page follows it.

Ageing you can click

Five buckets from 0–30 to 120+, each one a filter. Measure age from the patient-responsibility date or the date of service and watch the picture change.

Signals, not statuses

Each account carries one derived signal — paid, in credit, payment received, plan documented, question open, note missing, needs review — worked out from the ledger rather than typed by a human.

A write-off queue with lanes

Accounts flagged after the third statement split into three: paid since that statement, follow-up already documented, and payment status undocumented. The third lane is where the work is.

The arithmetic, spelled out

Open an account and the drawer shows how the number was reached — claim context, every payment, every statement, the notes, the review history, and the patient's other encounters at other sites.

Notes that change the account

Categorised, authored and timestamped. Choosing a category can set the payment arrangement and the next follow-up date, so a note is a commitment rather than a comment.

Decisions kept as history

Six decisions, none of which overwrite the last. Superseding a decision marks it superseded and keeps it, so the record shows what was believed and when.

Sites compared side by side

Open balance, exposure past 91 days, collection rate and queue depth per location, so an outlier site is visible without building a report.

Export what you are looking at

The current filtered view as CSV, stamped with the data mode and snapshot date. Cells are escaped so a spreadsheet cannot execute what is in them.

Built on your ModMed data, in one direction only

ModMed stays the source of truth. Clearside reads exports and never writes back — there is no code path that sends anything to your practice-management system, which is the first question every practice asks and the easiest one to answer.

  1. ModMed reports export
    Seven standard report exports, dropped on a schedule or run by hand.
  2. The CSV adapter reads them
    Handles $1,234.56, parenthesised negatives, four date formats and “Last, First” names, and maps ModMed note types onto ours.
  3. Clearside serves the view
    Balances, ageing, signals and the review queue — recomputed, never stored twice.
CSV export adapter

Working and round-trip tested. A sync replaces the tables ModMed owns, then deliberately re-attaches every note and review decision written in Clearside — so refreshing your data never destroys the audit trail.

FHIR R4 adapter

A stub, and honestly labelled as one. ModMed’s FHIR API returns demographics and locations but does not expose patient-ledger financials, so the money has to come through the CSV path.

What we need from you to connect a real tenant is written down in full — report names, columns, delivery method and access scope — before anyone asks for a credential.

A write-off you can defend

The queue exists to stop two specific mistakes: writing off money a patient has already paid, and writing off money nobody ever tried to collect.

  1. 01

    The biller flags it after the third statement

    Nothing enters the queue on a timer. An account arrives because a person sent three statements and got nothing back.

  2. 02

    Clearside sorts it into a lane

    Of the 215 accounts waiting, 48 have been paid since that third statement and should never have been written off. 52 already have a documented follow-up. 115 have no payment context at all.

  3. 03

    Four checks, validated by content

    A referral to collections needs a positive balance and all four checks completed — not ticked, completed. Closing an account as paid is refused outright while a balance is still open.

  4. 04

    The decision becomes the record

    Who decided, when, on what evidence, and what was believed at the time. A later reversal is added to the history rather than swapped in over the top of it.

In the demo dataset, 48 of the 215 accounts queued for write-off have been paid since the statement that flagged them. Writing those off is not a rounding error — it is money given away twice.

What Clearside does not do yet

Written down so an evaluation is not built on the wrong assumption. Every item here is a decision we have made about sequence, not something we are hoping you will not notice.

No authentication yet
Anyone who reaches the URL sees everything, and the note author is a free-text field. Single sign-on with site-scoped roles is the gate before this touches real patient data.
Nothing is written back to ModMed
A recorded decision is a record, not an action. A person still posts the adjustment in the practice-management system, which stays the source of truth.
Sync is manual and full-replace
There is no schedule and no incremental import. Notes and review decisions survive a refresh; nothing else is preserved between runs.
No trend history
Clearside answers where you are now, not whether you are improving. Comparing this month with last is not built.
No approval workflow
A write-off referred to collections is not routed to an approver. The queue records the decision; it does not chase a signature.

See it with your own numbers

The demo runs on synthetic data that behaves like a real sixteen-site practice. Connecting your own ModMed exports takes a set of reports and a place to drop them.