Insurance verification in seconds, not minutes.
The AI Eligibility Agent runs full benefits checks across hundreds of payers before the patient walks in. It reads coverage, copays, deductibles, and plan limitations — and flags issues before they turn into denials.
Why this gets built next.
Front-desk teams burn hours on payer portals every day. Stale or missing eligibility data is one of the top denial drivers across every specialty.
Capabilities, end to end.
Real-time eligibility and benefits verification via 270/271 and payer portals
Discovers active coverage for self-pay patients
Identifies coverage gaps, plan changes, and termination dates
Calculates patient responsibility estimates pre-visit
Pushes verified data back to your EHR/PM in structured fields
From signal to action in under a minute.
Ingest
Reads from your EHR, PM, clearinghouse, or payer feed. Zero rip-and-replace.
Reason
The agent applies RCM-trained logic, payer rules, and confidence scoring.
Act
Submits, escalates, or hands off to a human — with full audit trail.
Outcomes our customers measure.
reduction in front-desk verification time
clean eligibility rate at point of service
drop in eligibility-related denials
Questions, answered.
Which payers do you support?
All major commercial plans, Medicare, Medicaid, and most regional payers. Custom payer integrations available.
How long does setup take?
Most clients are live within 2 weeks for standard EHR integrations.
What happens when the agent isn't sure?
Low-confidence checks route to staff with a flagged work queue and the agent's reasoning attached.
See AI Eligibility Agent in action.
Book a 30-minute demo built around your payer mix and specialty.
HIPAA · SOC 2 Type II · BAA included