The Revenue Doctrine
The healthcare industry is bleeding $20B annually. Untested AI agents will only accelerate the loss. We don't replace your human staff; we deploy an Orchestration Layer to stop the bleeding and put them in command.
The Liability Reality
Clinical directors aren't losing sleep over LLM benchmarks or EU compliance. They are terrified of two things: their revenue cycle silently bleeding out from integration failures, and their human staff being forcibly replaced by black-box algorithms they can't trust.
$20B
Annual Leakage
Lost across the industry due to eligibility blind spots, authorization timeouts, and coding drift.
25%
Denial Rate
Of all claims are denied or delayed because of minor human data entry errors in the pre-visit phase.
100%
Human Oversight
We don't replace your staff. We mandate that the human acts as the protocol engineer with final approval authority.
The Key Takeaway for Executives
The 4 Healthcare Revenue Leaks
The healthcare revenue cycle is bleeding. If any link in the chain breaks, the money disappears. Here is how we deploy our low-risk Orchestration Layer across the 4 critical failure points.
Pre-Visit Check-In
Front desks waste 8+ hours a day on phone tag. 60% of claim denials are caused by simple eligibility issues before the patient even walks in.
The Orchestration Fix
The Receptionist Agent intercepts HL7 data from your existing legacy kiosks, autonomously querying Availity for real-time X12 270/271 eligibility. No need to rip out your hardware. High reward, zero lock-in.
$ RUN X12_270_ELIGIBILITY_REQUEST
ISA*00* *00* *ZZ*AV09311993 *ZZ*PAYERID *260224*1435*^*00501*000000001*0*P*:
GS*HS*AV09311993*PAYERID*20260224*1435*1*X*005010X279A1
... AWAITING 271 RESPONSE ...
$ PATIENT_COVERAGE_VERIFIED : TRUE
$ COPAY_CALCULATED : $25.00
Sarah Johnson
BlueCross BlueShield #A12B34
During Visit
Providers spend 2 hours a day on documentation. They deliberately under-code complex visits just to finish their shift, leaving $50K+ on the table annually per provider.
The Orchestration Fix
The Encounter Agent listens ambiently, generating structured SOAP notes and precise ICD-10/CPT codes. The provider simply taps "Approve" and the structured FHIR payload maps directly back into Epic or Cerner.
Patient: The pain is mostly in my lower back, it radiates down my left leg.
Provider: Does it feel sharp, or more like a dull ache?
Patient: Sharp, especially when I bend over.
Subjective: Patient reports sharp lower back pain radiating down the left leg, exacerbated by bending.
Post-Visit Claims
Claims sit in a 45-day A/R void. 15-25% are denied for minor missing modifiers. Billers drown in a backlog of manual recoding and resubmissions.
The Orchestration Fix
The Billing Agent scrubs the 837 claim against millions of payer-specific edit rules *before* it hits the clearinghouse, automatically applying modifiers to yield a 99% clean claim rate.
Claims Scrubbing Queue
22 ReadyClaim #837-A91B
98% First-Pass Confidence
Claim #837-C42X
Denial Predicted (UHC Rules)
ERROR: CPT 99214 requires modifier -25 when billed with procedure 20610.Patient Collections
Patients abandon care and ignore bills because they receive confusing statements six weeks after the visit. Practices collect pennies on the dollar via collections agencies.
The Orchestration Fix
The Patient Financial Agent translates complex EOBs into plain-language text messages. It delivers exact cost breakdowns and one-tap payment links the moment the claim clears, increasing collection rates by 300%.
Clear Mind Billing
Automated Assistant
Insurance covered: $280.00
Your copay balance: $70.00
The Key Takeaway for Executives
Stop the Bleeding
Don't wait for your revenue cycle to collapse under the weight of untested AI. Deploy the Orchestration Layer and empower your staff today.