Verify eligibility, extract benefits, and submit prior authorizations in real time — reducing denials, preventing errors, and accelerating reimbursement.
"Prior authorization requirements are identified automatically during documentation. No more surprises after the fact."
Michael Rodriguez
Practice Administrator · Coastal Orthopedic Group
HealOS scans insurance cards, EHR details, and demographics using OCR + AI to identify payer, plan type, and policy data.
The system queries payer portals and APIs to confirm active coverage, effective dates, plan type, and network participation.
Copays, deductibles, coinsurance, out-of-pocket limits, authorization needs, and referral requirements — all in seconds.
AI compiles payer-specific authorization packets and submits through the correct channel — API, EDI, or fax.
Automate eligibility checks, benefit extraction, prior auth, and payer compliance end-to-end.
Verify patient insurance coverage instantly across commercial, Medicare, Medicaid, and managed care plans before every visit.
Extract copays, deductibles, coinsurance, out-of-pocket max, effective dates, limitations, exclusions, and PA requirements.
AI extracts clinical data, builds payer-ready auth packets, and submits through the correct channel — no manual data entry.
Voice AI calls insurers automatically, navigates phone trees, extracts coverage details, and logs results to your system.
Identify coverage issues, missing authorizations, and high-risk claims before services are delivered to prevent denials.
Automatically re-verify coverage at scheduling, check-in, and pre-billing to catch changes in patient insurance status.
Coverage data, plan details, and patient cost estimates flow directly into your EHR and revenue cycle system.
Identify prior auth requirements for orthopedics, cardiology, oncology, behavioral health, and other specialties automatically.
| Feature | HealOS | Availity | Waystar |
|---|---|---|---|
| Real-time eligibility verification | |||
| AI-powered data extraction (OCR + NLP) | |||
| Automated prior authorization | |||
| Voice-enabled verification | |||
| Continuous insurance monitoring | |||
| Denial prevention alerts | |||
| AI scribe included | |||
| Starting price | $0 (free tier) | Custom | Custom |
See how AI automates your insurance workflows —
Book a Demo"We eliminated 90% of manual eligibility checks. The AI verifies coverage, extracts benefits, and flags issues before we even see the patient."
Jennifer L.
Billing Manager · Valley Family Practice
