Your AI Agent Workforce for Encounters Management

Meet your
Patient AccessFinancial Clearance
Team

Pre-Service Clearance Agent

Automate verification of patient coverage and determine if prior authorization is required before services are rendered, preventing denials and guaranteeing reimbursement.

Scheduling System
Patient:Sarah Johnson
Service:MRI Brain
Date:12/20/24

Encounter Created

Verify eligibility and check auth requirements

Agentic Process
Eligible
Active
Prior Auth
Required

Agent Verifies

Update EMR with clearance results

EMR Update
Coverage verified
Prior auth needed
Staff notified

EMR Updated

Prior Auth Submission Assistant

AI works alongside your staff to streamline the prior auth submission process. Over time, custom agents are generated to completely automate more of the work.

Auth Request
Service:MRI Brain
Payer:Aetna
Priority:Urgent

Prior Auth Required

Route to Karma for staff + AI processing

Agentic Process
Gathering docs
Form populated
Staff review

Karma Processing

Staff reviews and approves AI work

Payer Submission
Method:Portal
Status:Submitted
Time:8.5 min

Submitted to Payer

Prior Auth Follow-Up Agent

After prior auth requests are submitted, we continuously update the status of the request to ensure timely approval, improving patient experience and protecting reimbursement.

Auth Tracker
Auth ID:PA-2024-789
Service:MRI Brain
Status:Under Review

Auth Submitted

Continuous monitoring every 30 minutes

Agentic Process
Checking status
24/7 Active
Last check: 5 min ago

Agent Monitors

Real-time updates and staff notifications

Staff Notifications
Auth Approved
EMR Updated
Team Notified

Staff Updated

Trained Auth Submission Agents

Custom agents generated from your assistant's work to fully automate specific workflows

Cardiology Prior Auth
CPT Codes:93000-93799
Payer:Aetna
Plan:Better Health
NPI:1234567890
MRI Prior Auth
CPT Codes:70551-70553
Payer:BCBS
Plan:PPO Plus
NPI:0987654321
Surgery Prior Auth
CPT Codes:20000-29999
Payer:UnitedHealthcare
Plan:Choice Plus
NPI:1122334455
Specialty Care
CPT Codes:99201-99215
Payer:Medicare
Plan:Advantage
NPI:5566778899

Ready to Optimize Your Patient Encounters?

See how our AI agents and assistants can streamline registration, accelerate prior authorizations, and improve patient experience.