Who It's For
Billing teams and revenue cycle leaders
Practice managers and administrators
Claims processors and specialists
Anyone responsible for reducing denials
What It Does
Pre-Submission Review
Reviews claims for completeness before submission to catch issues early
Missing Detail Detection
Flags missing patient, provider, or service details automatically
Payer Rules Check
Highlights potential issues based on payer rules and past outcomes
Clear Fix Guidance
Suggests clear fixes so staff can resolve issues quickly
Status Tracking
Tracks status and organizes follow-ups in one place
Consistent Process
Documented processes across locations and shifts
Outcomes & ROI
Measurable impact on your operations and bottom line
Fewer Denials
Reduced denials and write-offs through proactive checking
Less Rework
Minimize time spent on resubmissions and appeals
Faster Reimbursements
Quicker payments through higher first-pass acceptance
Steadier Cash Flow
More predictable revenue with consistent processes
How It Helps
Higher first-pass acceptance with fewer avoidable errors
Less time spent on resubmissions and appeals
Clear, staff-friendly guidance on what to fix and why
Better visibility into what's pending, urgent, and next
Popular Use Cases
See how teams are using the Claims Management Agent
Pre-Submission Checks
Accuracy and completeness verification before submission
Returned Claims Review
Quick review with step-by-step fixes for rejected claims
Payer-Specific Guidance
Avoid common pitfalls with payer-specific rule checking
Organized Follow-Ups
Track status with notes your whole team can see
Agent Skill Sets
Specialized capabilities for comprehensive claims management
Coder
Smart coding assistance and validation
Denials
Denial prevention and management
Appeals
Streamlined appeals process
Prior Authorizations
Prior auth tracking and management
Scrubber
Claim scrubbing before submission