OpenBots

AI-powered chatbot solution for customer interactions

AI-driven solution that listens passively in the background, transcribing patient encounters and extracting data directly into EHR with minimal human intervention

Automated outbound payer calls with conversational intelligence, hold detection, payer-specific adaptation, and real-time monitoring

AI browser agents that navigate 200+ payer portals for eligibility checks, claim submissions, prior auth requests, and EOB downloads 24/7

Visual care program designer with automated care plan lifecycles, milestone tracking, patient engagement workflows, and outcome-based triggers

Case management and process insight capabilities with human in the loop

AI agent that automatically reviews, generates, validates, and routes healthcare claims, achieving 8X faster claim submissions

Smart claims management with expected reimbursement, NCCI validation, AI scoring, and denial management

Machine-readable files and patient cost estimation tools meeting federal transparency mandates

AI agent that reviews denials, categorizes root causes, drafts payer-specific appeal letters, and prevents future denials, achieving 30% fewer denials

AI-powered document classification and extraction capabilities

AI agent for indexing and classifying incoming faxes and structured/unstructured patient data with 98% accuracy

AI-powered document classification, multi-channel ingestion, SLA management, and intelligent queue routing

GAAP-compliant healthcare GL with contractual allowances, Gross vs. Net A/R tracking, auto-posting from RCM, and 13 report tabs

Event-driven eligibility workflows with real-time verification, batch processing, coverage discovery, and automated patient notifications

Coverage discovery, COB automation, three-touch verification, and financial clearance with AI-powered coordination

Streamlines insurance eligibility verification and prior authorization with autonomous AI execution achieving 97% first-pass approval rate

ML-powered routing, direct payer integration with 6 payer connectors, AI voice agents, and automated appeal management

Purpose-built workflows, documentation templates, and AI models for Mental Health, Chronic Care, Senior Care, Wound Care, Physical Therapy, Addiction Medicine, and Dermatology

Real-time integration with major payers including UHC, Anthem, Aetna, Cigna, Humana, and Medicare

Integration with electronic health record systems

AI agent that automates charge capture, optimizes medical coding accuracy, and reduces administrative burden with 95% accuracy and 70% reduction in coding time

AI-powered hybrid coding with ICD-10/CPT suggestion, confidence scores, CDI grading, denial prevention, and provider queries

AI agent that handles payment posting from payers with ERA/835 processing, achieving 100% match rate on EOBs

Automated ERA/835 processing with variance engine, CARC classification, granular thresholds, and auto-posting

Pricing model where OpenBots platform pays for itself within first 90 days

AI-powered credentialing lifecycle with document processing, automated verification, multi-payer enrollment, and compliance monitoring including OPPE/FPPE tracking

Automation of repetitive tasks across payer portals, EHR systems, and clearinghouses including file handling, data extraction, claim status checks, and multi-system orchestration

Real-time dashboards, SLA monitoring, payer scorecards, and comprehensive operational analytics

Guard policies, action allowlists, and safety rails preventing AI agents from taking unauthorized actions on payer portals

AES-256-GCM credential vaults, PII/PHI scrubbing, SSRF protection, and sandboxed execution for all autonomous agents

Every claim, denial, payment, and user action logged with immutable audit records

Full audit logging, BAA available, and PHI safeguards across every workflow

Aligned with HHS OIG seven elements including exclusion screening, E/M distribution analysis, and billing audits

X12 837/835/278/270/271 transaction standards for claims, remittance, and eligibility

Native standards-based interoperability with EHR systems, payers, and HIEs

Customizable business rules for routing, auto-posting, approval thresholds, and workflow automation

Automates patient intake forms and referral processes to free up employee time

Drag-and-drop workflow builder with AI nodes, event triggers, conditional logic, and pre-built templates for eligibility, claims, and denials

End-to-end referral tracking with smart patient matching, SLA management, and UM integration

Priority-based work queues with assignment rules, SLA tracking, and automatic escalation