Are you still running eligibility manually?
Well that’s a problem OpenBots can fix.
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The Real Pain:
Denials from Eligibility Errors
Eligibility isn’t just slow — it’s inaccurate when done manually. And those errors are the
#1 driver of claim denials in healthcare.
Denial Impact (2024 Optum Denials Index): 24% of denials are directly attributed to eligibility & registration manual errors (Optum Denials Index).
What Goes Wrong During Manual Eligibility
50%
Coordination of Benefits (COB) errors — wrong payer billed first
25%
Coverage lapses between scheduling and visit date
15%
Benefit maximums reached without notice
10%
Data entry mistakes (DOB, member ID, policy mismatch)
What Automation Fixes
OpenBots runs eligibility checks instantly — across any payer, clearinghouse, or EHR. It
flags every error before the claim ever reaches a payer.
Validates COB sequencing
Confirms plan coverage & benefit limits
Re-verifies eligibility automatically within 7 days of service
Updates EHR or spreadsheet in real time
Real Results from Providers
| Metric | Manual | Automated |
|---|---|---|
| Eligibility Denial Rate | >3% | <1% |
| Manual Workload | 100% | <5% |
| Verification Time | Minutes | Seconds |
| Cost-to-Collect | >4% | <2% |
“Eligibility verification is needed on every single patient. Our eligibility AI Agent has eliminated the #1 source of preventable denials, centralized the eligibility process for large intake teams and given countless hours back to focus on patient care.”
Zia Bhutta, CEO, OpenBots
Real Case Studies
See how providers are preventing denials through automation:
Large Behavioral Health Organization
Reduced denials from eligibility errors below 1%
Regional Treatment Center
Automated COB validation and EHR updates across all payer portals
Orthopedic Specialty Clinic
Automated eligibility verification and eliminated manual rework
Built on the OpenBots Agentic AI Platform
Your Eligibility AI Agent runs on OpenBots’ HIPAA- and SOC2-certified platform —
purpose-built for healthcare automation.
Automation AI
Document AI
Customer AI Chatbots
Case Management & Process Insights
Human in the loop
EHR Integration
Watch: Eligibility — The #1 Denial Driver in Healthcare
Join Gabriel Skelton and Rano Banerjee as they break down:
- Why clearinghouses miss COB, benefit limits, and coverage lapses
- How agentic automation verifies eligibility end-to-end
- Real-world ROI from behavioral health and treatment center clients
- How to scale automation across payer networks
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
