Accelerate reimbursements, reduce A/R, and eliminate manual follow-up work with enterprise-grade automated claims follow-up. HealOS uses AI Agents to track claim status, perform payer follow-up, detect delays, and recover outstanding payments, ensuring no claim ever slips through the cracks.
Traditional claims follow-up is slow, manual, error-prone, and heavily dependent on administrative staff. These challenges directly hurt revenue, cash flow, and staff productivity:
Teams spend hours logging into payer portals, navigating IVR systems, and checking claim statuses, leading to delays and missed follow-ups.
Payers use ambiguous status messages and varying formats, creating confusion and leading to errors during follow-up.
Without automation, aged accounts accumulate quickly, causing lost revenue and increasing the risk of claims becoming uncollectible.
RCM teams juggle spreadsheets, emails, and portal screenshots reducing focus on high-value revenue recovery.
By the time staff notice a stalled claim, it's often too late. AI enables early detection before revenue is lost.
HealOS analyzes claim age, payer behavior, code type, denial risk, and financial value to prioritize follow-up on claims most likely to generate fast reimbursement.
AI Agents log into payer portals, check adjudication status, verify processing stages, and trace missing claims, performing follow-up continuously without human intervention.
Automated phone calls, portal checks, and compliant email workflows push stalled claims forward. AI navigates IVR menus, checks status codes, submits documents, and logs outcomes.
Machine learning detects high-risk claims, unusual delays, and payer deviations enabling early escalation before accounts reach 90+ days.
AI identifies missing clinical notes, attachments, codes, or required forms. It alerts your team or automatically sends the missing documents through the correct payer workflow.
HealOS syncs with denial management to trigger appeals or resubmissions immediately after a denial, ensuring fast resolution and accelerated payment.
AI compares expected vs. actual payments using payer contracts. Variances, underpayments, and incorrect adjustments are flagged instantly for recovery.
Every payer is different. HealOS learns each payer's rules, patterns, response timelines, and preferred communication channels, improving personalization and follow-up success.
Track follow-up volume, aging trends, denial patterns, payer behavior, and financial impact across your entire revenue cycle.
HealOS uses AI, RPA, and intelligent monitoring to streamline every step of the claims follow-up lifecycle.
AI retrieves claim statuses from payer portals, clearinghouses, and APIs, running large batches automatically so your team never checks statuses manually.
Machine learning decodes payer messages, CARC/RARC codes, pending reasons, and "no claim on file" responses to determine exact next steps.
High-risk claims, aged claims, and claims with missing information are routed to smart queues, while low-risk claims are tracked automatically.
HealOS performs payer calls, portal checks, email updates, and documentation submission without human intervention.
AI resolves straightforward cases automatically and sends complex cases to staff with full context, attachments, and recommended actions.
Claims are rechecked at optimal intervals. AI tracks updates around the clock until payment is posted.
AI eliminates delays by performing follow-up instantly and continuously.
Claims are monitored hourly improving payment speed and accuracy.
Intelligent prioritization increases recovery of aged accounts.
Teams avoid repetitive portal checks, spreadsheets, and calls.
Automation frees teams to focus on appeals, audits, and strategic RCM tasks.
Healthcare systems using automation see full ROI in 20–30 days—thanks to faster follow-up, reduced hours, and recovered revenue.
HealOS connects with claims submission, denial management, eligibility verification, payment posting, and analytics creating a unified RCM automation ecosystem.
Like top competitors, HealOS uses AI agents capable of decision-making, pattern recognition, and autonomous follow-up actions.
Executives and RCM directors get instant visibility into AR days, projected cash flow, payer performance, denial trends, and follow-up outcomes.
Automation performs the work of 5–10 staff members, enabling expansion without hiring during seasonal spikes or practice growth.
HealOS is built for medical billing, payer workflows, and healthcare compliance—not generic automation.
Works with EHRs, PM systems, clearinghouses, and payer portals.
Healthcare groups consistently achieve 40% fewer A/R days, 25% higher recovery rates, and major staffing efficiency gains.
Fully HIPAA-compliant with audit logs, encryption, access controls, and traceable workflows.
Plug-and-play setup with no disruption to current workflows.
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