The Challenge
Why this matters
Healthcare organizations face real, measurable pain in billing & insurance workflows. Here's what we see every day.
15% average claim denial rate
The healthcare industry averages a 15% claim denial rate. Each denied claim costs an average of $25 to rework and can take weeks to resolve.
Eligibility not checked before visits
When insurance eligibility isn't verified before the appointment, practices face surprise denials and patients get unexpected bills.
Failed payments untracked
When a credit card charge fails, most practices lose the revenue unless a staff member manually notices and follows up.
Prior authorization bottlenecks
Prior auth documentation is manually assembled, causing delays in patient care and revenue recognition.
Solutions
AI Workflows We Build
7 AI workflows we build and manage for billing & insurance. Click any card to see how we deliver it.
Failed Payment Resolution
When a payment gateway registers a failed charge, automatically log and trigger resolution workflow.
Self-Pay Case Flagging
When eligibility check shows self-pay or out-of-network, tag the patient and trigger cost-estimate workflow.
Real-Time Payment Sync
When a payment is confirmed, automatically update the patient profile across all systems.
Invoice Payment CRM Update
When an invoice is marked paid in billing system, instantly update the CRM record.
Prior-Auth Document Automation
When patients submit insurance cards or lab orders through intake portal, automatically process and route.
Benefits Verification Notifications
When benefits verification is completed, automatically notify patients and clinical teams of results.
Pre-Visit Eligibility Tickets
When an intake form arrives, automatically pass demographics to eligibility check and create a verification ticket.
Process
How It Works
Unlike self-serve platforms, we handle everything. Three steps to AI-powered billing & insurance workflows.
1. Assess
We audit your current billing & insurance workflows, identify bottlenecks, and map which automations deliver the highest ROI.
2. Build
We configure integrations, build automation pipelines, and test everything with your real data before going live.
3. Run
We monitor, maintain, and optimize your automations on an ongoing basis. You focus on patients, we handle the tech.
Integrations
Systems We Connect
We connect with 100+ healthcare systems. Here are the tools we integrate most often for billing & insurance.
Don't see your system? Contact us — we integrate with virtually any healthcare platform via API, HL7, or FHIR.
FAQ
Frequently Asked Questions
How do you reduce claim denials?
We automate pre-visit eligibility checks and prior-auth document assembly. By catching issues before the appointment, we dramatically reduce downstream denials.
Can you recover failed payments automatically?
Yes. When a payment gateway registers a failed charge, we log it, notify your billing team, send the patient a retry link, and escalate unresolved cases.
Do you integrate with our billing software?
We work with all major platforms including Stripe, Square, Candidhealth, pVerify, QuickBooks, and Waystar for end-to-end billing automation.
How does eligibility verification automation work?
When an intake form arrives, we extract demographics and insurance info, run an automatic eligibility check, and create a verification ticket with results for your team.
Can you handle self-pay patient workflows?
When an eligibility check shows self-pay or out-of-network, we automatically tag the patient, generate a cost estimate, and offer payment plan options.
Ready to Automate Billing & Insurance?
Book a free assessment and we'll map your billing & insurance workflows, identify quick wins, and show you exactly what we'd automate first.