Supervised AI agents for intake and eligibility.
Front-office staff re-key referral data and run coverage checks patient by patient, across payer portals and clearinghouses that all work differently.
Where the time goes
Referrals arrive as faxes and portal messages and are re-typed into the intake system. Eligibility and benefits checks run patient by patient across payer portals and clearinghouses. Demographic and coverage mismatches slip through and surface later as denials.
What the agent takes on.
Enters referral and demographic data into the intake system Runs the eligibility check in the payer portal or clearinghouse Records coverage, copay, and authorization-required flags on the case Cross-checks demographics between the referral and the coverage response Flags mismatches and exceptions instead of guessing
Where staff stay in the loop
Terminated coverage and coordination-of-benefits conflicts route to staff for a decision Staff can review any intake before it is finalized Every check and entry is recorded in the audit trail