Foundational Operating Lane · Printable Brief
Records-to-Demand
The foundational proof and delivery lane within Catena’s Managed Pre-Lit Operations Platform—carrying treatment and records follow-through from first request to a verified demand package.
- Provider & CPT billing audit — Rejects bare balance summaries and chases itemized ledgers
- Zero vendor rip-and-replace — Coordinates with your retrieval vendor or a Catena supplier
- Demand staged for review — Verified chronology, specials, and draft ready for attorney authority
Watch how Catena resolves gaps and stages the demand (42s)
Inspect the 6-step walkthrough transcript
1. Matter #2048 assigned to Catena (00:00–00:04). Four providers; S. Jenkins (your paralegal) keeps the file while Catena carries the follow-through. Grady EMS records and itemized bill are requested, returned, and verified.
2. A returned record isn’t a ready file (00:04–00:11). Peachtree Ortho returns a bare balance summary—no CPT codes and no itemized bill.
3. Catena chased it; your paralegal didn’t (00:11–00:19). Catena rejects the balance summary, requests the itemized ledger, and verifies all 14 service lines without a handoff.
4. New treatment appears; readiness reopens (00:19–00:27). An 08/14 follow-up note references a new lumbar MRI. Catena pauses readiness while keeping verified records locked.
5. One question goes to the firm—records attached (00:27–00:35). Catena routes the legal call to S. Jenkins with both options and the supporting PDFs attached: hold the demand for MRI results, or proceed on the 07/31 cutoff. Everything else continues.
6. Your firm decides; Catena carried the rest (00:35–00:42). When the firm answers (“Hold for MRI results”), Catena adds the records, prepares the chronology and specials, and stages the demand for your review. Valuation, sending, and settlement stay with you.
01 · End-to-End Execution
Five stages from assignment to demand ready.
Route a defined set of matters, an overflow/30-day stall rule, or a standing segment. Click any stage to inspect the operational work Catena carries:
01 · Maintain requirements across the matterDynamic provider, date-range & billing tracking
Establish required records, itemized bills, and treatment periods under your firm’s policy. Update requirements dynamically as new providers or treatment dates are identified.
02 · Execute requests and persistent follow-throughRun through your retrieval vendor or a Catena supplier
Send authorized requests through your existing retrieval vendor or a Catena-managed supplier, track provider waits, and pursue outstanding returns without requiring your paralegals to chase status.
03 · Verify returns and resolve deficienciesCatch bare balance summaries & missing CPT codes
Evaluate every returned document against matter requirements. Catch missing date ranges, incomplete pages, and bare balance summaries lacking CPT line items; initiate and verify corrections.
04 · Establish evidence-backed readinessLink verified source pages to readiness state
Verify when governing criteria are satisfied, link the supporting evidence to the readiness state, and automatically reopen readiness if new treatment or conflicting information arrives.
05 · Prepare qualified demand packageAssemble chronology, specials & demand draft for review
Assemble verified records, itemized specials, and a substantive demand draft for attorney review—making any open issues or reserved decisions explicit.
02 · State & Evidence Discipline
Inspect the evidence behind every state change.
A document arriving in a folder does not mean a requirement is satisfied. CatenaOS shows what is required, what is verified, and what blocks readiness.
MVA Bodily Injury · Matter #2048
DOI: 04/18 · 4 Providers
Provider initially returned a bare $8,420 balance summary. Catena flagged the missing CPT codes, requested the itemized ledger, and verified all 14 dated service lines.
Readiness Reopened on New Treatment
08/14 follow-up note references a new lumbar MRI referral. Earlier verified records stay locked; readiness paused until resolved.
Hold demand for August MRI results or proceed with 07/31 cutoff?
When a matter is still in progress
- Exact gap identified: Which provider, date range, or CPT billing correction is outstanding.
- Next-action owner: What follow-up Catena is executing and when the next check occurs.
- Clear routing distinction: Whether the file waits on a provider return or a reserved firm decision.
When a matter reaches readiness
- Linked source evidence: Which verified records and itemized bills satisfy governing criteria.
- Recorded firm approvals: Which cutoff choices or deficiency waivers are logged in the record.
- Automatic reopening guard: How supplemental treatment automatically reopens state before dispatch.
Inspect example walkthrough: Billing deficiency + August MRI referral
1. Catching the deficiency: Under the firm’s criteria, an orthopedic provider requires both complete clinical notes and an itemized billing ledger through July 31. The provider returns clinical records alongside a bare balance summary with no service dates or CPT codes. Catena flags the billing return as deficient, requests an itemized ledger from the billing office, and verifies the corrected return matching patient, provider, dates, and charges.
2. Handling new treatment mid-stream: While the billing correction is completed, a follow-up note reveals a subsequent August MRI referral. Even though the July 31 bill is now satisfied, Catena keeps the matter in a non-ready state and routes the cutoff decision—with supporting records attached—to the firm’s designated reviewer.
03 · Governance & Ownership
Your firm keeps legal judgment and final authority.
Every engagement defines a clean boundary between delegated operational execution and your firm’s reserved professional decisions.
What Catena carries on assigned matters
- Requirements & chasing: Maintaining requirements, sending requests, and persistent provider follow-through.
- Verification & corrections: Return audits, gap reconciliation, and billing deficiency resolution.
- Readiness & staging: Evidence-backed readiness evaluation and demand preparation for your review.
What always remains with your firm
- Client & legal counsel: Client relationships, legal advice, and treatment-related legal judgment.
- Cutoffs & waivers: Treatment cutoff decisions, deficiency waivers, and reserved approvals.
- Valuation & settlement: Demand valuation, final edits, approval, sending, negotiation, and settlement.
04 · Founding Partner Onboarding
Start with a bounded set of files.
Evaluate Catena on real pre-lit work alongside your named operational counterpart before expanding to a standing rule.
Step 01 · Scope & Setup
- Select initial matters: Choose a defined set of eligible files or set a 30+ day stall rule.
- Connect existing stack: Confirm CMS access, retrieval vendor or Catena supplier mode, and decision owners.
- Agree written terms: Terms in writing before you decide; no separate platform fee during the founding period.
Step 02 · Calibration & Operation
- Side-by-side review: Verify initial readiness and demand preparation states with your operational counterpart.
- Live visibility: Track status, linked evidence, and next-step ownership in CatenaOS.
- Complete flexibility: Keep a selective routing rule, expand scope, or transfer matters back under structured handover.
Book a 15-minute conversation: https://cal.com/consult-recovery/catena-15min
Contact Catena: brian.mcleod@primeelixirco.com