Automates patient intake from insurance verification to clinical handoff.
A multi-provider practice handling 150+ patients daily loses 15-20 minutes per patient on intake paperwork. Front desk staff manually verify insurance eligibility by navigating payer portals, collect medical history on paper, process consent forms, and enter data into the EHR. Errors in insurance verification lead to claim denials — the average denial rate for eligibility issues runs 10-15% industry-wide.
The CMS Interoperability and Prior Authorization Final Rule mandates modernized intake processes by 2026. Practices still relying on manual workflows face both operational inefficiency and regulatory non-compliance. Phreesia and Clearwave have digitized parts of this workflow, but most solutions are form-digitization rather than intelligent document processing.
No-show rates average 18-25% for practices without automated reminders and pre-visit engagement. The intake experience sets the tone for the entire visit.
This agent handles the full pre-visit pipeline. Before the appointment, it sends patients a mobile-friendly intake flow collecting demographics, insurance information (including card photos for OCR extraction), medical history, medications, allergies, and consent acknowledgments. It runs real-time eligibility verification against payer APIs (Availity, Change Healthcare, Waystar) and flags coverage issues before arrival.
Medical history data is structured into FHIR-compliant resources mapped to your EHR's data model. The agent identifies gaps — missing immunization records, incomplete medication lists, unsigned consents — and follows up automatically. For returning patients, it pre-populates known data and asks only about changes.
At clinical handoff, the provider sees a structured summary in their EHR: verified insurance, reconciled medications, flagged allergies, and the patient's reason for visit mapped to relevant ICD-10 codes.
Built on Node.js with TypeScript, the agent connects to payer APIs (Availity, Change Healthcare, Waystar) for live eligibility queries and uses GPT-4 Vision for insurance card extraction. Patient-reported data is mapped to HL7 FHIR R4 resources and pushed to your EHR via Epic FHIR APIs, Cerner Open APIs, or the athenahealth marketplace. PostgreSQL handles structured intake records; Redis manages session state across the multi-step intake flow. Setup runs 3–4 weeks, HIPAA BAA included.
Queries Availity, Change Healthcare, and Waystar before the appointment to confirm active coverage, copay amounts, deductible status, and referral requirements. Results are surfaced to front-desk staff and written to the patient record—no manual payer portal logins.
Patients photograph their insurance card on their phone. GPT-4 Vision extracts member ID, group number, payer name, and plan type with structured validation against known payer formats. Eliminates front-desk re-entry and reduces transcription errors.
Converts patient-reported symptoms, medications, allergies, and history into HL7 FHIR R4 resources (Patient, Condition, MedicationStatement, AllergyIntolerance) and writes them directly to Epic, Cerner, or athenahealth. No manual chart prep for clinical staff.
Pulls known demographics, current medications, and prior history from the EHR before the intake session starts. Asks the patient only about changes since their last visit—cutting average intake time from 15 minutes to under 3.
Anonymized work with hard metrics — NDA-bound, no client names.
41%
Faster Critical Response
91%
Alert Precision
31%
False Alarm Reduction
“The false alarm rate was a genuine patient safety issue — staff were silencing monitors as a coping mechanism. The AI layer changed the signal-to-noise ratio enough that nurses are paying attention to alerts again.”
— ICU Clinical Director, Regional Medical Centre
We custom-build each agent to fit your data, your rules, and your existing systems.
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Fordel Studios