AgentConnectfor HMO claims
Hospital claims pre-checked. Your reviewers only open the exceptions.
AgentConnect pulls the charges from hospital bills and statements of account, flags errors and duplicates, and pre-adjudicates simple claims for a reviewer to confirm.
30-day money-back guarantee.
If it isn't working, you don't pay.
Before and after · estimated ranges
- Pre-check of a simple hospital claim
- 15–30 min by handUnder 5 min to confirm
- Claims a reviewer opens in full
- All of themThe exceptions
Estimated ranges for simple inpatient and outpatient claims, to be confirmed in your pilot.
Every hospital bill, checked line by line. By hand?
HMO claims teams and their BPO partners · 0:42Before and after · estimated ranges
- Pre-check of a simple hospital claim
- 15–30 min by handUnder 5 min to confirm
- Claims a reviewer opens in full
- All of themThe exceptions
Estimated ranges for simple inpatient and outpatient claims, to be confirmed in your pilot.
- Tasks automated
- 10Kor more
- Agents deployed
- 1Kor more
- Hours saved
- 100Kor more
- Consequential actions without your approval
- 0
As of October 2026
Today
Every hospital bill, line by line, by hand?
- 01
Every SOA keyed in by hand
Charges are read off hospital bills and statements of account and typed in, line by line.
- 02
Errors and duplicates found late
A double-billed item or a wrong amount is caught after payment, if it is caught at all.
- 03
Reviewers on simple claims
Your most experienced people spend the day on claims that only needed checking.
In the film
What the agent does, step by step.
- Every hospital bill gets checked line by line by hand: room, labs, meds and limits.
- AgentConnect reads the SOA and checks every bill line against the member’s plan and limits.
- A duplicate lab line is held for the claims reviewer. Once they approve, the claim is settled and the duplicate stays unpaid.
- Today
- Hospital claimUnchecked
- With AgentConnect
- Needs a humanDuplicate lab line flagged
Try it
Tell the agent what to do.
Type a job, or pick one below, and watch a simulated run get as far as your approval.
Where a person steps in
It stops before anything consequential.
These are the moments the agent hands to your team. Each decision is recorded with who made it.
- 01
Every claim decision
Simple claims are pre-adjudicated, and a reviewer confirms each one before anything is paid.
- 02
Errors and duplicates
Flagged with the line and the reason, for a person to decide.
- 03
Anything clinical or unusual
Goes to your medical or claims team. Never guessed.
What AgentConnect agents handle
- Extracts charges from hospital bills and SOAsHMO · Claims · handled end to end
- Pre-adjudicates simple claims for a reviewer to confirmHMO · Claims · waits for a person
- Flags duplicate charges for a reviewerHMO · Claims · waits for a person
- Pre-adjudicates simple claims for a reviewer to confirmHMO · Claims · waits for a person
Every step is logged. Anything consequential waits for a person.
Works inside your claims platform, your HMO core system and your document store. Nothing to migrate.
ROI calculator
What would it give back on hospital claims?
Put in your own numbers. The result updates as you type, and we can email you the full breakdown.
What AgentConnect would give back
- Hours back each month
- 300
- Value of that time, per year
- US$21,600
- Capacity freed
- 1.9 full-time people
Conservative estimate. Your numbers may differ.
Hours = volume × time per item × the share the agent takes on. A full-time person is 160 hours a month. Approval time isn't counted as saved. Currency rates are fixed, as of October 2026.
The guarantee
Live in 30 days, or your money back.
Your hospital claims workflow, from first call to running in your systems, in a month.
Week 1
Scoped with you
We map your use case with you: what the agent will run, and what it will hold for your approval.
Week 2
Connected to your systems
We build the agent and connect it to the systems the work already lives in. Nothing to migrate.
Week 3
Run alongside your team
It works real cases next to your people, with your approval step in place, so you can check every result.
Day 30
Live, or your money back
If it isn’t working on day 30, you don’t pay.
AI upskilling
Train your team to work alongside the agents.
A learning plan for every agent, built from their own skills check, so your people know how to review what the agents prepare, handle the exceptions and step in.
Questions
What people ask about this one.
Does it pay claims on its own?
No. It prepares the decision, and a reviewer confirms it before anything is paid.
What counts as a simple claim?
You decide. We agree the rules with you when we scope it: which benefits, which amounts, which hospitals.
Does it replace our claims platform?
No. It works inside your claims platform and HMO core system, alongside your team.
Keep watching
Now do it with your hospital claims.
Bring your own process to a working session. We’ll map what AgentConnect would run, what it would hold for approval, and how we’d have it live in 30 days.