Eligibility, prior authorization, claims follow-up, denials, ePHI workflows. We've shipped automation for hospital networks, multi-site practice groups, telehealth platforms, and revenue-cycle service providers — with HIPAA, audit trails, and BAAs treated as table stakes.
Each of these is in production at one or more US healthcare clients today. Volume, exception handling, and SLAs are configured per engagement.
Bots query payer portals, parse 270/271 responses, and update the EMR with copay, deductible, and coverage status — including the messy edge cases like duplicate plans and tertiary payers.
Submit, track, and follow up on prior auth across payer portals and fax fallbacks. AI handles document assembly; bots handle the click-work and status-checks.
Daily claim batching, payer submission, and 277/277CA status follow-up. Errors route to a triage queue with the exact field flagged.
CARC/RARC parsing, appeal-letter assembly, payer-specific re-submission rules. Recovers a meaningful tail of “written-off” cash.
Agentic AI reads, categorizes, and drafts responses for clinical, billing, and scheduling messages. Human review only on edge cases.
Statement generation, payment-plan logic, dunning sequences, and ePHI-safe communication across email, SMS, and mail.
Custom-built de-identification pipelines for analytics, research, and vendor data sharing — Safe Harbor or Expert Determination paths.
CAQH attestation, payer enrollment tracking, expirations monitoring, and document re-collection — the back-office no one wants to staff.
30 minutes with a senior engineer. We'll know whether RPA, AI, or “you don't need this” is the right answer.
Hey, I'm Karl, Co-Founder of Flobotics. Book a free consulting session with me and let's see if we can help.
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