AI AGENT
Automate UHC Verifications And Prevent Claim Denials
Verifying UnitedHealthcare (UHC) eligibility and benefits (EVB) manually requires staff to log into the UHC Link portal, navigate multiple tabs, and interpret complex benefit responses. This slows scheduling, creates administrative rework, and increases the risk of costly claim denials.
Infinx transforms this process with automation agents and AI agents that complete UHC EVB checks in real time. Automation agents manage the verification workflow within UHC systems, while AI agents extract, normalize, and interpret benefit data so your team gets exactly what they need to financially clear patients.
UHC offers a wide range of plans including Commercial, Medicare Advantage, and state-specific Medicaid plans. Each product has unique coverage rules, benefit accumulators, and authorization requirements. Our agents adapt by parsing these plan responses, isolating coverage logic, and surfacing service-specific requirements such as prior authorization for high-cost imaging or specialty medications. Over time, AI agents improve accuracy by learning from your organization’s historical UHC verifications, which reduces manual intervention and denial risk.
EASY UHC ELIGIBILITY AND BENEFITS VERIFICATION
Submit Eligibility Verifications to UHC from your EMR
Get instant, accurate UHC EVB results directly through your EMR, PMS, or our platform. Manual UHC checks through the Link portal slow workflows and increase denial risk. With our automation and AI agents, you can:
- Check eligibility in seconds: Instantly confirm plan-level and procedure-level coverage for UHC members.
- See cost details in advance: View copay, coinsurance, and deductible before care is delivered.
- Avoid costly claim denials: Identify and flag eligibility errors or incomplete benefit data before they impact reimbursement.
- Improve patient communication: Share clear coverage and benefit details before care.
Patient Access Plus integrates seamlessly with your existing systems to deliver real-time UHC eligibility and benefit details, helping your team work faster, reduce errors, and keep patients informed.
HOW IT WORKS
A fully automated solution for verifying UHC eligibility and benefits
Once patient and service information is submitted, our automation agents and AI agents work together to complete the verification process with UHC. Here’s how it works:
Patient Access Plus triggers automation agent
When patient and service information is submitted, the automation agent initiates eligibility verification with UHC through the Link portal or clearinghouse connections.
The AI agent parses and organizes benefit details
The AI agent extracts key benefit data such as coverage status, deductible, copay, and coinsurance. It normalizes UHC’s response formats 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 UHC requires a manual check, such as with certain regional Medicaid or Medicare Advantage plans, 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.
