Healthcare
Clinical coding support
Coders get a ranked list of candidate codes with the supporting text from the record, looked up in the official code sets, for them to accept or change.
Custom app
Healthcare · Automation
Insurance eligibility checks
AI insurance eligibility and benefits verification before visits
Coverage and benefits are checked electronically before every appointment, and problems go to the front desk days ahead instead of at check-in.
01 today
The problem
Front-desk staff check insurance by phone or portal, one patient at a time, often on the day. Inactive coverage or a missing referral is found at check-in, and visits are delayed or claims are denied later.
02 the run
What the AI does
- Step 1: Reads upcoming appointments a few days ahead from your scheduling system.
- Step 2: Runs electronic eligibility checks with each payer for every patient.
- Step 3: Reads the response for coverage status, co-pays, deductibles and any referral or authorisation needed.
- Step 4: Flags problems, such as inactive coverage or a missing authorisation, for the front desk to resolve before the visit.
- Step 5: Saves the result to the patient's account so check-in and billing use the same information.
paused: waiting for a person to approve
03 human in the loop
Where a person approves
Front-desk staff contact patients about any coverage problem and decide how to proceed. The tool never cancels or reschedules a visit on its own.
04 after
What changes
Coverage problems are solved before patients arrive, check-in is quicker, and fewer claims are denied for eligibility reasons.
Case studyCoverage problems solved before the patient arrivesThe rollout, what to measure, a worked example and the research behind it.see also
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