AgentFoundry

The Challenge

Administrative complexity

Fragmented data sources and partner systems complicate administrative workflows.

Heavy reliance on repetitive, manual workflows slows decision-making and increases error risk, driving up costs.

Navigating dynamic regulatory and policy changes requires precision, creating pressure to keep up.

Our Solution

Agent Library

Boost care team efficiency and reduce avoidable costs through personalized, evidence-based guidance.

Generates evidence-based, personalized care plans that improve clinical outcomes and care coordination.

Accelerate medical review cycles and reduce administrative costs through intelligent automation.

Evaluates clinical records against medical policies to determine medical necessity, highlight key evidence, and accelerate authorization decisions.

Reduce processing time and rework by automating document validation and completeness checks.

Automates validation of submitted clinical documents to ensure completeness, reduce delays, and support faster, compliant reviews.

Improve quality scores and incentive performance through proactive, data-driven gap identification.

Identifies open care gaps and recommends targeted actions to boost quality scores, compliance, and member outcomes.

Increase reimbursement accuracy and coding compliance while reducing manual review burden.

Detects and applies accurate risk codes to improve documentation integrity, compliance, and reimbursement accuracy.