Pre-visit intake
History, medications, allergies, family and social history, and review of systems, completed by the patient on their phone.
08 · Patient experience
AI Intake & Eligibility Agent
Front-desk staff should not be retyping insurance cards while patients wait. Intake and eligibility run before the visit, and the chart is ready when the patient walks in.
Agent at a glance
- StatusIn development
- CategoryPatient experience
- Deployment2–4 weeks, shadow mode first
- Review modelHuman approval per action, configurable
- Headline metric< 2% Registration errors
- EvidenceFull action log, exportable any time
24 hrs → 2 hrs
Intake completion
Typical compression once intake is sent ahead and chased.
< 30 sec
Eligibility check
Real-time verification with deductible and co-insurance detail.
< 2%
Registration errors
Versus the double-digit error rates common in manual entry.
What it does
Everything in this agent, in writing.
Consents and signatures
HIPAA notice, financial policy, treatment consent and telehealth consent captured electronically with a timestamp.
Insurance capture
Card photos, OCR extraction and plan matching, with member ID validated against the payer.
Real-time eligibility
Active coverage, deductible, co-insurance, copay, out-of-pocket maximum, and whether the service is covered.
Structured EMR write-back
Answers mapped to the exact fields and coded values your EMR expects, not a PDF in a documents folder.
Prior balance and payment
Existing balance, financial policy and payment options presented before the visit, with card-on-file where you allow it.
Deployment
Live in weeks, not quarters.
01
Form and field mapping
Your paper forms and EMR fields mapped to a single digital intake.
02
Eligibility testing
We run your top payers and compare results against your current verification process.
03
Pilot cohort
A subset of patients first, with front-desk feedback daily.
04
Full rollout
All patients, with paper kept available for anyone who wants it.
Guardrails
What it will never do.
These limits hold regardless of configuration. They exist so that you can put an agent in front of patients without putting your licence next to it.
- PHI entered directly into your environment, not held in a marketing database
- Consent text version-locked so you can prove exactly what a patient agreed to and when
- Eligibility results presented with the source and timestamp — never a silent guess
- Patients who cannot or will not use digital intake are never blocked from care
- Accessibility and language support built in, including low-literacy plain-language mode
Human in the loop, by your choice
Every action can require approval before it commits. Start with all of intake agent queued to your staff or to ours, watch the accuracy numbers, then widen autonomy workflow by workflow — or leave it queued forever. Both are supported.
Escalations land with certified people
Our review queue is staffed by the same certified coders, billers and credentialing specialists who run our managed services. Not a support desk, and not a chatbot watching a chatbot.
Full evidence trail
Input, decision, action, confidence, model version, reviewer and timestamp — retained and exportable as CSV or JSON, including after you leave us.
What we report against
Operational targets for this agent. They are internal commitments measured on your own data, reported monthly — including the misses.
< 2%
Registration errors
< 30 sec
Eligibility
80%+
Digital completion
< 5 min
Front-desk saving per visit
Works with your systems
Your EMR, your numbers, your data.
- Athena
- eClinicalWorks
- NextGen
- Epic
- Tebra
- Elation
- Availity
- Change Healthcare
- Waystar
We integrate through FHIR and HL7 where the vendor supports it, and through secure automation or structured document intake where it does not. No API required, no vendor commission taken.
FAQ
Common questions.
Will it work with our paper forms?
Yes. We digitise your existing forms first, so the questions patients answer are the ones your practice actually asks — not a generic intake template.
What if a patient does not use a smartphone?
They complete intake on a tablet at the desk, by phone with the agent, or on paper. Digital-first is not digital-only.
How accurate is eligibility?
We use real-time payer transactions and show the source and timestamp of every result. Where a payer returns ambiguous data, we flag it for staff rather than telling a patient the wrong copay.
Does it handle Medicare and Medicaid?
Yes, including Medicare Advantage and state Medicaid managed-care plans, with plan-specific rules applied.
Related agents
Usually deployed together.
09
In development
AI Recall & Care Gap Agent
Works your recall list and quality gaps continuously: overdue screenings, missed follow-ups, annual visits and chronic care check-ins — outbound, in your voice, with the appointment booked.
- Overdue recalls and quality gaps worked continuously
- Outbound outreach that ends in a booked visit
- Closes HEDIS and MIPS gaps with the documentation to prove it
10
In development
AI Prior Authorization Agent
Checks whether a service needs authorization, assembles the clinical packet, files it, and tracks every request to a decision — with the deadlines that matter.
- Requirement checked before the service is scheduled
- Clinical packet assembled from the chart automatically
- Every request tracked to a decision, with deadlines enforced
11
In development
AI Denials & Appeals Agent
Works deny-rail and clearinghouse rejections continuously: categorises each denial, drafts the appeal with clinical support attached, and escalates the patterns that keep recurring.
- Every denial categorised, owned and worked to resolution
- Appeals drafted with the clinical documentation attached
- Root-cause patterns fed back to coding and the front desk
See it run on your own workflow.
A 30-minute demo using your scenarios, your payer mix and your systems. We will show you the guardrails and the audit log, not just the happy path.
A 30-minute call with an operations lead. No obligation, no sales sequence, and we will say so if you do not need us.