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Claims

Turn healthcare claims into collected revenue.

You have Healthcare claims
You get Collected revenue

You pay When cash comes in

  • Calls
  • Email
  • Documents
  • Systems
  • Follow-up
  • Exceptions
Hire this Agent Start a Pilot

What you give it

  • Claim files or EDI feeds
  • Payer list and contracts
  • Billing system access
  • Provider identifiers
  • Appeal templates
  • Escalation contacts
  • Write-off thresholds

What it owns

  • Agent owns
  • Agent + human
  • Human decision
  1. Claim Agent owns
  2. Validation Agent owns
  3. Submission Agent owns
  4. Follow-up Agent owns
  5. Denial handling Agent + human
  6. Appeal Agent + human
  7. Payment Human decision

What it can do

Communicate

  • Phone
  • Email
  • Payer portals

Work with information

  • Validate claim information
  • Detect missing information
  • Assemble appeals
  • Read remits

Operate software

  • Billing software
  • Payer websites
  • File systems
  • APIs

Coordinate

  • Check status
  • Handle denials
  • Submit appeals
  • Escalate cases

You decide what the agent is allowed to do.

Action Permission
Validate claim information Allowed
Submit claims Allowed
Communicate with payers Allowed
Handle denials Allowed
Assemble and submit appeals Allowed
Update billing software Allowed
Write off balances above threshold Requires approval
Change fee schedules Not allowed

Humans stay in the loop.

The agent owns execution. Your team handles judgment, authority, or escalation.

Agent handles 92% Example of execution
Exception detected The job pauses on a rule
Human decision Judgment, authority, or policy
Agent continues work Execution resumes after the decision

Run it against your operation.

Illustrative example
Your Team Agent
Work items 1,000 100
Completed 180 24
Conversion 18.0% 24.0%
Average cycle time 21.0d 11.0d
Cost per outcome $94 $51

Start with 10% of the work.

Measure the same outcomes you measure. Increase volume when the agent earns it.

Start a Pilot

Works with the systems you use.

The pilot should require little systems change.

  • API
  • Email
  • Spreadsheet
  • CRM
  • Browser
  • Shared Inbox
  • Database
  • File Upload
  • Internal Software
Hire this Agent