AI AGENT
Automate Availity Verifications And Prevent Claim Denials
Verifying eligibility and benefits (EVB) manually through payer portals is slow, inconsistent, and increases the risk of claim denials. Infinx removes this burden with a direct API connection to Availity. Our automation agents and AI agents retrieve eligibility and benefit data in real time, delivering structured responses directly into your workflow without manual navigation or clearinghouse delays.
Automation agents manage the API transactions with Availity, while AI agents parse, normalize, and interpret the payer responses. Together, they provide complete coverage and benefit details including eligibility status, copay, coinsurance, deductibles, visit limits, and prior authorization indicators. This ensures your staff can financially clear patients quickly and accurately.
Because Availity connects to a wide range of payers, response formats vary across Commercial, Medicare Advantage, and Medicaid plans. Our AI agents adapt by interpreting these payer-specific differences, normalizing the data, and surfacing requirements relevant to the service. If an API response is incomplete, fallback logic automatically routes the case to our expert specialists, who complete the verification and close the loop.
EASY Availity ELIGIBILITY AND BENEFITS VERIFICATION
Submit Eligibility Verifications to Availity from your EMR
Get instant, accurate EVB results from Availity delivered directly into your EMR, PMS, or our platform. Manual Availity verifications slow workflows and increase the risk of claim denials. With our automation and AI agents, you can:
- Check eligibility in seconds: Instantly confirm plan-level and procedure-level coverage across payers connected through Availity’s API.
- See cost details in advance: View copay, coinsurance, and deductible before care is delivered.
- Avoid costly claim denials: Identify and flag eligibility gaps or missing requirements before claims are submitted.
- Improve patient communication: Share clear coverage and benefit details before care.
Patient Access Plus integrates seamlessly with your existing systems to deliver real-time eligibility and benefit data through Availity, helping your team work faster, reduce errors, and keep patients informed.
HOW IT WORKS
A fully automated solution for verifying eligibility and benefits through Availity
Once patient and service information is submitted, our automation agents and AI agents work together to complete the verification process through Availity. Here’s how it works:
Patient Access Plus triggers automation agent
When patient and service information is submitted, the automation agent connects to Availity’s API to initiate eligibility verification.
The AI agent parses and organizes benefit details
The AI agent extracts payer-specific benefit data such as coverage status, deductible, copay, coinsurance, visit limits, and prior authorization indicators. It normalizes Availity’s multi-payer responses into a structured, easy-to-read format.
The AI agent identifies and flags errors
If errors are found in patient registration or if benefit responses are incomplete, the AI agent flags them for correction before the claim is submitted.
Instant system update with specialist fallback
If Availity returns incomplete or errored data, the automation agent routes the case to our expert specialists, who complete the verification and close the loop.
Verified eligibility and benefits in your system
All confirmed information is delivered by the automation agent into a centralized dashboard accessible to schedulers, front desk, or billing staff.
