Intelligent automation simplifies eligibility checks, guidelines, and submissions, reducing delays, speeding up approvals, and improving access to oncology treatments
Eligibility & Benefits Verification
Checks patient insurance coverage & plan specifics before care.
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Leverages FHIR/API calls to pull eligibility data in real time
Applies payer-specific rules to flag coverage gaps or prior auth needs
Calculates out-of-pocket responsibility up front
Prior Authorization
Automates submission and tracking of PA requests to payer portals, ensuring complete and accurate documentation.
Auto-populates and submits payer-specific forms from EHR data
Validates clinical criteria against NCCN, CMS, and payer guidelines
Monitors portal status continuously & escalates stalled requests
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Denial Management
Turns denied claims into recovered revenue.
Detects high-risk claims pre-submission using payer-rule engines
Tracks appeal outcomes and feeds insights back into the hospital’s system
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Claims Management
Orchestrates end-to-end claims from creation through payment.
Validates CPT/ICD coding against live payer rulebooks
Submits claims via EDI/API and alerts on exceptions instantly
Reconciles remittance advices and updates claim status in the RCM
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Payment Posting
Automates posting of payer and patient payments into the billing system, matching adjustments and flagging mismatches.
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Parses EOB/EOPs to extract payments, adjustments, and write-offs
Matches and posts payments to corresponding invoices automatically
Flags mismatches or short-pays for rapid human review
BOSS for X
Rapidly deploys Agentic AI to high-friction financial process.
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Our advanced technology play
Intelligent automation simplifies eligibility checks, guidelines, and submissions, reducing delays, speeding up approvals, and improving access to oncology treatments
Dynamic DAGs
Our Backbone of Automated Pipelines
Revolutionary runtime pipelines that auto-generate and sequence AI-agent tasks per case. It simplifies automation, adapting in real time to new data and evolving payer rules, and scaling seamlessly as clinical complexity grows.
Gen AI and LLMs:
Fine-tuned transformer models and NLP pipelines that parse structured & unstructured EHR data, aligns it with payer & clinical guidelines, auto-generate audit ready justification narratives.
RPA and Rules Engine:
High velocity automation of repetitive tasks like eligibility checks, form population, portal nav. powered by embedded payer rules and historical data.
Human Experts:
Precision oversight to validate and refine AI outputs, handle edge cases, and continuously train the system
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