HEALTHCARE AGENTS · CLAIMS, DENIALS AND APPEALS
HOW IT WORKS
01
Start from the prebuilt agent
It already knows referrals, claims, remittances and fee schedules, and the checks your team runs on them.
02
Configure it to your tools, systems and parameters
We connect Epic or athenahealth, Availity, Waystar and your referral inbox, and load your contracts, standards and approval chain.
03
Release it into the work
It starts on live work. Our platform checks every draft against its source and stops where a person must approve.
04
It works like a trained member of your team
Work arrives ranked and drafted. Your team approves, and nothing reaches a patient or payer without sign-off.
OUR PLATFORM
Your contracts, standards, thresholds and approval chain, plus what your team knows, written down as the playbook the agent follows.
Every tool connected where it sits, one record per patient, and every figure traced to its source.
Every draft is checked against its source and your rules, and the agent stops where a person has to approve.
It sees only what the person it works for can see, your BAA obligations apply, and every step is logged.
THE SYSTEMS IT READS
Referrals, scheduling and encounters
Claim lines and expected reimbursement
Eligibility and prior authorisation
835 remittances and denial codes
Clearinghouse rejections
The fee schedule that was agreed
Referrals nobody triaged
Documentation supporting the charge
Cases, minutes and surgeon
Supplies consumed per case
One ledger per clinic
Older practice management extracts
FAQ
By reading the contract. The agent compares the signed fee schedule rate with what each remittance paid, and finds short payments on claims that were adjudicated and closed.
No. It comes prebuilt for payer contracts and remittances, and we configure it to your 835 remittances, payer agreements, claims register and denial log, including scanned contracts.
No. The agent drafts and prices each demand with the evidence attached, and the revenue cycle lead approves before anything goes out. It also tracks every contractual notice window.
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