AUTOMATION AGENT
Automate claim status follow-ups with ease
For radiology providers, a hidden bottleneck in the A/R recovery process is the tedious task of tracking claim status updates across multiple payers. When claims haven’t received a response from payers, or claims have been previously worked but require adjudication information, staff need to request information from payers and then continually check to see if the payer has responded.
This process is time-consuming—requiring manual logins and juggling passwords—and often leads to missed updates. As these claims age, the risk of write-offs increases, creating additional pressure on your team to recover revenue that could have been saved earlier in the process.
Our Claims Status Follow-Up Automation Agent with Crime Victims Compensation Program (CVCP) helps solve this problem by automating the process of following-up with payers. It uses robotic process automation (RPA) to check statuses through the CVCP portal, pull updates, and directly enter them into your system. This ensures nothing gets overlooked and helps you recover aging A/R before it turns into a write-off.
Available as part of the A/R & Denials Management platform (ARDM) workforce management module or as a standalone automation agent in our Revenue Cycle Agent Platform, providing the flexibility to automate claims status follow-ups in a way that aligns with your existing workflows.
INSTANT ClAIMS STATUS UPDATES
Crime Victims Compensation Program responses delivered directly to your system
Automatically track claim approval requests and receive accurate status updates—without staff intervention.
- Our automation agent eliminates manual logins, and status checks by pulling payer responses from CVCP directly into your system.
- Automated updates ensure approved, denied, or pending statuses are reflected automatically, keeping staff informed and speeding up the appeals process.
- Scalable automation handles high volumes of claims, reducing administrative workload.
Along with the CVCP agent, we provide additional claim status follow-up agents that work together to cover a broad range of payers through integrations with platforms such as Availity, Healthfirst, United Healthcare, and others.
With automation agents working 24/7, you can ensure timely and accurate claims tracking while reducing need for manual follow-ups.
HOW IT WORKS
A fully automated solution for tracking claim status
Once our automation agent is assigned a claim status check request, either through direct system integration or bulk upload, it begins executing the task. With the claims status automation agent running in the background, staff can focus their time on working complex claims, while ensuring timely updates from payers.
Denials management system triggers automation agent
When a claim is moved to the automation queue, or staff initiate the automation in our Revenue Cycle Agent Platform, the automation agent is automatically assigned the follow-up task.
Claim status retrieval
The automation agent retrieves the latest status (Approved, Denied, or Pending) directly from CVCP via robotic process automation.
Instant system update
Your system is automatically updated with the latest claim status, ensuring real-time visibility for your staff.
For denied cases, the response will include the EOB/Remittance Advice from CVCP.
Ongoing follow-ups
For unresolved cases, the automation agent re-engages with CVCP at set intervals (e.g., every 6 hours) until a final decision is reached.
With continuous tracking and automated updates, your team can stay on top claim status updates and resolve denials faster.
