Automate eligibility verification and prior auth across 1500+ payers

95% reduction in verification time
80% lower processing costs
8x more verification per hour

Unified automation for all payer-facing tasks

Susan, our bespoke AI agent, handles all manual tasks for your insurance discovery and eligibility needs.

STEP 1

Patient Coverage Check

Susan starts by checking if insurance information is present in the patient's records, including member ID & provider details. If any crucial information is missing, Susan automatically notifies the intake team.

STEP 2

Insurance Discovery

When member ID isn't available, Susan automatically searches across insurance databases to find active coverage. Sam checks multiple sources including Medicare and Medicaid to ensure no coverage is missed.

STEP 3

Real-time Eligibility Verification

Susan verifies insurance coverage in real-time, checking if the specific services are covered under the patient's plan. This includes confirming the provider network status and service type coverage.

STEP 4

Benefits Summary

Susan generates a comprehensive benefits summary showing copays, deductibles, out-of-pocket maximums, and covered services. If multiple insurance policies are found, Sam flags this for proper coordination of benefits