LogoContact Us
Solution 02

Automated control & submission

Agentic AI orchestrates validations, edits, and submissions so your team focuses on exceptions—not repetitive work. Every claim is checked against payer rules and your operating playbooks before it ever leaves the door.

Get in touch
Agentic AI submission board
Clean claims auto‑submitted>98%
Claims needing review~1%
Blocked by payer rules5–6%
Rules refresh automatically with payer bulletins, coding updates, and your own operating playbooks.
Live controls for every submission
Eligibility & coverage checks
Code edits & modifiers applied
Missing documentation prompts
Payer‑specific rules enforced
Every step is tracked for auditability with human override when needed—without slowing down throughput.
Standard operating procedures (SOPs), built into every submission

Your SOPs don't sit in binders—they drive how work actually runs. Define, control, and audit SOPs directly in the submission flow so every claim follows the same playbook.

Follow, control, and audit compliance to SOPs at the level of each provider, location, and payer.

Build SOPs easily with configurable rules that dictate submission paths, required documentation, and exception management.

SOP compliance dashboard
Active SOPs, encounters, and historical success / failure rates.
Active SOPEncountersSuccessFailure

Policy number recovery

842 encounters

93%

7%

Unacceptable primary diagnosis corrections

312 encounters

88%

12%