We automate the administrative work. Clinical decisions stay with people.
Payer teams spend hours on intake, correspondence and provider data changes. We can automate those administrative steps. Clinical, medical necessity and benefit decisions stay with your staff.
We automate
- Reading and sorting documents
- Pulling out key fields
- Routing to the right queue
- Entering data between systems
- Logging every step
People decide
- Clinical decisions
- Medical necessity
- Benefit interpretation
- Claim and authorization decisions
- Anything unclear
Administrative work we can automate
Intake
We read incoming applications and documents, pull out the key fields and send each one to the right queue. Incomplete ones are flagged.
Correspondence
We sort letters, faxes and appeals, link each one to the right case, and send anything unclear to a person.
Provider data
We check change requests, such as a new practice address or phone number, and queue the updates for your provider directory.
Data entry between systems
We move data between your core platform, CRM, case management and spreadsheets, and log every step for audit.
We know payer systems from the provider side.
For labs and providers, we’ve built automations that work in UnitedHealthcare, Availity and other payer portals: status checks, medical record uploads, reconsiderations and appeals. That includes 16 workflows with UnitedHealthcare for our lab clients.
We haven’t worked for a health plan directly yet. We would bring the same engineering to your side: the documents, queues and systems your staff works in every day.
Every automation logs what it read, what it did and when, so your team can check every step. Anything the automation isn’t sure about goes to a person, with the reason.
We automate the administrative steps: reading, extracting, routing and entering data. Clinical decisions, medical necessity and benefit decisions are never automated.
If you run payer operations, tell us which administrative queue costs you the most time. We’ll tell you honestly whether automation pays off.
News: states regulating AI in prior authorization and claims decisionsShow us the payer queue that costs you the most time.
Let Karl, our CTO, take a look. We’ll tell you honestly whether automation pays off.
Walk me through the process your team does by hand. I’ll tell you whether it’s worth automating and how I’d approach it.
Karl