AI + Automation for RCM

Reasoning plus execution inside Healthcare Revenue OS, AI that decides the next step and automation that completes it.

HEALTHCARE REVENUE OS

Built for revenue cycle execution, not AI experiments

Most teams end up on one of four paths: hire more staff, outsource to traditional services, automate with bots that break on exceptions, or add standalone AI tools that suggest actions but do not complete the work.

We take a different approach, AI and automation are delivered as part of Healthcare Revenue Operating System, working with the other OS layers, integrations, payer connectivity, workflow orchestration, controls, and insight, to produce outcomes, not just recommendations.

This AI + automation layer powers our three agent suites, Patient Access Plus, Document Capture Plus, and RCM Plus. Start with a suite for your biggest bottleneck, then add targeted agents as needs evolve.

WHY IT WORKS

Make automation resilient to real-world variability

Revenue work breaks when data is incomplete, rules change, or exceptions stack up. We connect decisioning to execution, so routine work completes, and edge cases move forward with the right context instead of stalling in queues.

What changes when reasoning is connected to execution:

  • Next-best action is selected using workflow and payer context
  • Routine steps are completed across systems, not handed off
  • Exceptions surface early, with clear ownership and priority

The result is fewer manual touches and less rework across the revenue cycle.

Why teams choose Infinx for agents

It is not enough to have AI that can draft or summarize. Revenue teams need capabilities that perform specific skills reliably, inside real workflows, with visibility and accountability. What makes our agents practical in production:

  • Agents are designed as skills tied to real workflows
  • Execution happens across systems and payer channels, not just recommendations
  • Exceptions are surfaced with context, priority, and ownership
  • Delivered as suites plus add-ons, so you start fast and expand cleanly

This is why our agents hold up when volume, variability, and timelines are real.

AGENT SUITES

Choose the suite that fits your bottleneck

Each suite bundles the AI and automation needed for a common set of workflows, with the ability to add agents when exceptions or volume demand it.

Patient Access Plus 
Automate financial clearance, eligibility, and authorization work, then surface exceptions before they become rework. This suite helps prevent preventable downstream denials and delays.

RCM Plus 
Reduce downstream status chasing and follow-up effort with automated execution and prioritized exceptions. This suite keeps follow-up continuous so A/R does not age from stalled work.

Document Capture Plus
Turn faxes, PDFs, and uploads into structured data that routes into the right workflow. This suite converts unstructured intake into clean workflow inputs.

Start with a suite, then expand coverage without changing how you run revenue work.

OUR AGENTS

Skills that remove manual touches

Here are some of our agents built around the skills revenue teams rely on every day, document understanding, payer execution, and continuous follow-up that does not stall.

Document Capture Agent
Extract, classify, and route documents. Pulls key information from inbound documents, classifies the document type, and routes the output into the right workflow so teams stop re-keying data. This turns intake into structured work, automatically.

Claims Status Agent 
Retrieve status, interpret responses, update workflows. Automates claim status retrieval across payers, interprets responses, and updates workflows so teams do not spend hours chasing portal updates. This reduces aging risk by keeping follow-up continuous.

Auth Follow-up Agent
Track, escalate, and prevent missed authorizations. Monitors authorization status across channels, escalates when timelines slip, and keeps downstream work aligned to what is approved and when. This helps prevent authorization delays from turning into denials or reschedules.

Medical Necessity Copilot
Apply payer policy logic to reduce preventable denials. Flags documentation gaps and medical necessity risk earlier by applying payer policy criteria to the clinical context for targeted review. This helps reduce avoidable denials tied to missing or misaligned documentation.

The three agent suites are the fastest way to start. When you want to extend coverage, use our agent catalog to browse add-on agents and copilots by workflow, from patient access to document capture to downstream RCM.

HOW TEAMS START

Standardize one workflow, then expand coverage

Most teams begin with a single workflow where manual touches are highest and outcomes are measurable. Once the baseline is live, expanding is a matter of adding suites or agents, not rebuilding your operating model.

A typical adoption path looks like this:

  • Start with one suite aligned to your bottleneck
  • Add agents to extend coverage across adjacent work
  • Scale with shared workflows, reporting, and controls

Best fit for teams with high manual touch volume, multiple payer channels, and frequent exception work.

Start small, prove value quickly, then scale what works.

INTEGRATIONS

Connect with your EHR and billing systems

Integrate through HL7, FHIR, APIs, and RPA where needed, then write updates back so teams do not rekey or chase status across portals. HIPAA-aligned controls support BAA, encryption, role-based access, and audit logging.

Integration is how automation becomes operational, not extra work.

Faq

Answers to common questions about our agents

If you are trying to reduce manual touches, keep work moving through exceptions, and scale without adding headcount, these are the questions we hear most often.

Agents are delivered through Agent Suites and add-on agents, supported by the operating layers that keep workflows connected, governed, and measurable. You get execution that holds together, not a standalone tool.

Suites are the fastest way to standardize a set of common workflows. Add-on agents extend coverage for a specific bottleneck without changing your overall operating model. Suites start the journey, add-ons expand it.

Reasoning selects the best next action using context and workflow rules. Execution completes the step across your systems and updates the workflow, then flags exceptions when human judgment is needed. The point is to finish the work, not just recommend it.

We support HL7, FHIR, and APIs where available, plus RPA for steps that still require portal navigation. Updates can be written back to reduce rework. The outcome is fewer clicks, fewer portals, and fewer handoffs.

HIPAA-aligned controls include encryption in transit and at rest, role-based access, and audit logging. A BAA can be supported as part of deployment. Security is designed in, not bolted on.

Yes. The product packaging evolved, and what we previously described as Healthcare Revenue Cloud is now positioned as Healthcare Revenue OS. The architecture is consistent, the positioning is clearer.

Most teams go live in phases, starting with one workflow and the right Agent Suite. Timeline depends on the systems involved and the workflow scope, but the goal is to launch quickly, prove impact, then expand to adjacent work. Start with one measurable workflow, then scale once it is working.

We support HL7, FHIR, and APIs where available, and use automation for payer portal steps when integrations are limited. The objective is to reduce manual swivel-chair work while keeping updates written back into your workflows. If your team has to log in and check it, we can usually automate it.

Agents are designed to complete routine work, then surface exceptions when data is incomplete, rules are ambiguous, or payer responses are unclear. Exceptions can be routed with the context required for fast resolution, and workflows can include audit trails and controls. Automation handles the repeatable work, humans focus on what needs judgment.

Agent Suites provide a packaged starting point for a set of workflows. Add-on agents extend coverage for specific bottlenecks, and pricing typically aligns to what you deploy and the workflows you run, not a one-size-fits-all bundle. You pay for the coverage you need now, and expand as value is proven.

Faq

Questions about Healthcare Revenue OS

If you are evaluating any of our solutions, these are the most common questions teams ask about the operating system that powers the solution, how it fits with your environment, and how the Agent Suites and services are delivered.

Healthcare Revenue OS is The Operating System for Healthcare Revenue. It unifies revenue work into one operating system that connects systems, automates routine steps, and routes exceptions with control across patient access and RCM workflows.

Point solutions typically improve one task, then leave your team to manage the gaps between steps, handoffs, rekeying, status chasing, and exception routing. Healthcare Revenue OS coordinates eight connected layers so the system holds the workflow together end to end.

Traditional outsourcing often relies on humans doing the work with limited platform support and limited workflow control. With Healthcare Revenue OS, outsourced execution can be delivered by Infinx teams working inside the operating system, which improves productivity and consistency versus a human-only model.

Because denials, A/R delays, and high cost to collect are created in the gaps, not just within one step. The eight layers close those gaps by combining AI and automation, integrations, workflow execution, human-in-the-loop routing, security, and insight into one coordinated system.

They are Agent Suites powered by Healthcare Revenue OS. Each suite runs inside the same operating system and uses the same eight layers, so you can start with one suite and expand without adding new tools or rebuilding workflows.

Agent Suites provide broader workflow coverage within a domain. Add-on agents are targeted capabilities you add when a specific bottleneck appears, and they run inside Healthcare Revenue OS using the same routing, controls, and visibility.

No. Healthcare Revenue OS is designed to work with your environment. It connects to provider systems and payer channels so workflows can be executed and updated without rip and replace.

Healthcare Revenue OS executes routine steps through AI and automation. When work requires judgment or payer-specific handling, it routes exceptions to humans with context, priority, and clear ownership, and then returns outcomes back into the workflow.

Healthcare Revenue OS includes ongoing operational oversight across layers to keep workflows reliable as payer rules, integrations, volumes, and exception patterns change. That oversight maintains playbooks, routing, integration health, and performance improvement over time.

Most teams start with the highest-impact workflow lane or one Agent Suite, align on what should be automated vs handled by humans, connect the required systems, and expand once performance stabilizes and exception handling is running smoothly.

Put AI and automation to work for RCM

If you want AI that can decide the next step and automation that completes it, start with the Agent Suite that matches your highest-friction workflow. Most teams begin with one area, then expand quickly once exception handling, routing, and integrations are in place.