AI Agent for Claims Processing

OpenBots Claims AI Agent automatically reviews, generates, validates, and routes healthcare claims by fully automating the steps that are traditionally handled by human claims processors, coders, and billers.

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OpenBots AI Claims agent automates and streamlines various aspects of the insurance claims process, significantly reducing processing time and human error. It handle tasks like claim generation, data extraction, validation, and even fraud detection.

Core Features

1

Claims Intake & Parsing

Intelligent processing of multiple claim formats with advanced parsing capabilities.

2

Data Validation

Comprehensive validation against multiple databases and rule sets for accuracy.

3

Automated Adjudication

Smart claim processing with payer integration and intelligent coding logic.

4

Denial Prevention & Resolution

Predictive analytics and proactive resolution for maximum claim success.

5

Communication & Submission

Seamless integration with clearinghouses and automated status tracking.

6

Analytics & Reporting

Comprehensive insights and real-time dashboards for performance optimization.

From a technical requirements and scoping perspective, it’s been excellent working with the team. I appreciate how detail-oriented they are and how clearly they define what they want to achieve. Overall, it’s been such a positive experience working with OpenBots!  

Theresa Jackson Director of Technology, Complete Care Centers
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