Eligibility & verification automation
Pre-visit eligibility checks run automatically the night before. Exceptions flagged in the morning huddle. Copay due amounts pushed to the front desk on arrival.
From $6,5008:1 typical
Vertical · Regulated, PHI-aware
Healthcare automation that puts front-desk hours back into patient time.
Clinical practices, multi-physician groups, ambulatory care, hospitalist consortiums. The healthcare automations we ship most are eligibility, charge capture, scheduling, and prior auth. HIPAA-aware patterns, data-separation postures you can defend in a compliance review, and Quick Wins that get hours back to the people who actually see patients. We sign BAAs.
The basics
What healthcare automation actually covers.
Automation in healthcare is the work of taking the back-office workflows that wrap around your EMR — eligibility and verification, charge capture, scheduling and recall, prior auth, patient communication — and running them automatically under HIPAA-aware governance. It is not about replacing clinical judgment; it is about removing the manual handoffs that pull staff away from patients. Done well, healthcare workflow automation gives the front desk and the billing room hours back while keeping PHI inside your tenant and every action audit-logged — the same governed-by-default posture we run for law firms.
The problems
Where the hours go in a healthcare back office.
Healthcare back offices have the same shape: scheduling, verification, charge capture, claims, follow-up. Each has hours hiding in manual handoffs.
Problem 01
Scheduling and verification eat the front desk.
Insurance verification, eligibility checks, prior auth, copay collection, no-show follow-up. The front desk swivels between the EMR, the insurance portal, and a stack of sticky notes.
- Eligibility checked manually per appointment
- No-show rates above 10%
- Front desk doubles as call center
Problem 02
Charge entry lags the visit.
Providers chart, billers re-enter. Days of float between encounter and claim. Coding errors caught downstream, after the rework cost is sunk.
- Charge entry 2-5 days behind visits
- Coder rework rate above 8%
- Denials over manual data entry
Problem 03
Provider time goes to documentation.
Clinicians spend an hour on every two hours of patient time documenting. The EMR is the bottleneck, not the medicine.
- Documentation extends past clinic hours
- After-visit summaries by manual template
- Refill requests routed by phone
Quick Wins, healthcare
Healthcare automation Quick Wins we ship first.
The most-shipped Quick Wins for healthcare operators. Each one is fixed price, fixed date, scoped from the audit.
Charge capture & cleanup
Pull provider notes, flag missing codes, pre-validate against payer rules before the claim ships. Cuts denials and tightens the float between visit and claim.
From $8,5006:1 typical
Patient communication routing
Refill requests, lab questions, scheduling tweaks. Route by triage rules, draft replies with Claude under provider guardrails. PHI never leaves your tenant.
From $7,5005:1 typical
Recall & no-show recovery
Auto-schedule recall outreach, re-engage no-shows by SMS and email, fill cancellation slots from a waitlist. Front desk stops manually working a spreadsheet.
From $6,5007:1 typical
Prior auth tracking
A dashboard that shows every open auth, its payer, its expected turnaround, and what to do next. Cuts the "where are we on that?" loop.
From $9,5004:1 typical
AI scribe + chart pre-fill
Claude-backed dictation summarized into your EMR templates, pre-filled with the structured fields. Providers approve, edit, sign. PHI-aware, BAA-signed.
From $11,000Time, not dollars
Real engagement
Six-provider Raleigh clinic, charge entry from 5 days to 5 minutes.
A multi-physician primary care clinic in Raleigh, six providers, was running charge entry on a five-day lag. Billers re-keyed provider notes into the practice management system; denials trickled back two weeks later; rework rates were running 11%.
The audit surfaced three Quick Wins: charge capture from the EMR, payer-rule pre-validation, and a recall-and-no-show workflow. We shipped the first two in nine weeks combined, fixed price.
The denial rate is now under 4%. Charge entry is same-day (in practice, same-hour). The billing team has a real Friday again. The owner, who was working sixty-hour weeks, is not.
5 min
Charge entry lag, down from 5 days
4%
Denials, down from 11%
18 hrs
Reclaimed per week, billing team
$48k
Year-one savings on rework alone
Healthcare Q&A
Healthcare automation questions specific to your floor.
The questions we hear most from healthcare operators. For everything else, the general FAQ has more.
Are your patterns truly HIPAA-compliant?
We build HIPAA-aware patterns: data-separation, audit logging, access controls, BAA-signed sub-processors. Compliance is your responsibility and your compliance officer's; we give you a defensible posture and the documentation behind it.
Do you sign a BAA?
Yes. Before any work begins that could touch PHI. We have a standard BAA we send before kickoff, or we sign yours.
Will this break my EMR vendor agreement?
No. We integrate through documented APIs (FHIR, vendor REST, HL7) and respect the EMR's rules of engagement. We've never had a vendor pull a customer's integration access over our work.
Does Claude get to see PHI?
Only under a signed BAA, in the configuration that supports it. We default to never sending PHI to a non-BAA model, and we put guardrails on prompts that try to slip it through.
What about Epic? Can you actually integrate?
On the partner side, yes. Epic's App Orchard / Showroom programs are the path. We've done App Orchard work and can scope a partner engagement.
What is healthcare automation?
Healthcare automation means automating the back-office workflows around your EMR — eligibility, charge capture, scheduling, and prior auth — under HIPAA-aware governance. It takes the manual handoffs that eat front-desk and billing hours and runs them automatically, so staff time goes back to patients instead of portals.
Which healthcare workflows are easiest to automate first?
The fastest wins are eligibility and verification, recall and no-show recovery, and charge capture. Each is a contained, high-volume workflow with clear rules, so it ships quickly as a fixed-price Quick Win and pays back quickly.
Is healthcare automation HIPAA-compliant?
Our healthcare automation is HIPAA-aware: data-separation, audit logging, access controls, and BAA-signed sub-processors. Compliance stays your compliance officer's call; we give you a defensible posture and the documentation behind it.
How much does healthcare automation cost?
Healthcare automation starts with a $947 audit that scopes the work, then individual Quick Wins from $6,500 each at fixed price and fixed date. It is a ladder, not a leap: you climb to the next workflow only once the last one pays back.
Ready for healthcare
Modernize the back office, protect the front line.
The audit is HIPAA-aware from the first call. BAA signed before the shadow day. Math on the page in writing.