AUTOMATION AGENT
Automate claim status follow-ups with ease
For radiology providers, a key bottleneck in the A/R recovery process is the time-intensive task of tracking claim status updates across multiple payers. When claims haven’t received a response or require additional adjudication details, your team is left to manually follow up with payers and monitor for updates, a process that is both time-consuming and prone to missed responses.
Our Claims Status Follow-Up Automation Agent with Availity helps solve this problem by automating the process of following-up with payers. It uses API connection to check statuses, 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
Availity responses delivered directly to your system
Automatically track claim approval requests and receive real-time status updates—without staff intervention.
- Our automation agent eliminates manual logins, and status checks by pulling payer responses from Availity 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 API automation handles high volumes of claims in minutes, reducing administrative workload.
Along with the Availity 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 Healthfirst, United Healthcare, and others.
With automation agents working 24/7, you can ensure real-time 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 Availity via API.
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 Availity.
Ongoing follow-ups
For unresolved cases, the automation agent re-engages with Availity at set intervals (e.g., every 6 hours) until a final decision is reached.
With continuous tracking and real-time updates, your team can stay on top claim status updates and resolve denials faster.
