AGENTIC AI
Five agents. Every prior auth, start to finish.
Each agent owns one job: checking coverage, reading payer rules, submitting, tracking and handling fax. They hand off to each other and write every result back to your EMR. Your team handles only what the agents are not sure about.
One prior auth request
Echocardiogram · Medicare Advantage · illustrative
EXAMPLE
- 07:58 ELIGIBILITY AGENT Coverage verified Active plan, benefits and patient cost confirmed
- 08:01 POLICY AGENT Payer rule matched 6 of 6 criteria found in the chart
- 08:03 SUBMISSION AGENT Request filed Filed on the payer portal with clinicals attached
- 09:15 FAX AGENT Payer asked for more by fax Read, matched to the request and answered
- 10:42 AUTH STATUS AGENT Approved Decision and auth number written to the chart
WHERE THE AGENTS SIT
One layer of a four-layer platform.
The agents run on the same data foundation as every ColigoMed solution, so what one agent learns is there for the next.
Unified care continuum
Before, during and after every visit, on one platform
Solutions
Prior Authorization Automation · Touchless Eligibility & Benefits · Continuous Care · Readmission Risk
YOU ARE HEREAgentic AI layer
Eligibility · Policy · Submission · Auth status · Fax automation · Insights
Data Unifier Hub
Your EMR, HIE, remote monitoring devices and payer portals, connected
THE AGENTS
Each agent owns one job, end to end.
- AUTOMATEDRuns on its own. People see only the exceptions.
- HYBRIDAgent does the work. A person confirms when a payer rule is unclear.
- ASSISTIVEGives your team the information. People decide what to do with it.
PRIOR AUTHORIZATION
- AUTOMATED
Touchless eligibility agent
Checks coverage and benefits in real time and passes the result to every other agent.
- HYBRID
Policy agent
Reads each payer’s rules and matches them to the order and the chart.
- AUTOMATED
Submission agent
Files each request the way the payer accepts it: X12 278, the payer’s portal or fax.
- AUTOMATED
Auth status agent
Tracks every request until a decision and writes the result back to the EMR.
- AUTOMATED
Fax automation agent
Reads incoming payer faxes and sends outgoing ones where payers still require fax.
CARE MANAGEMENT
- ASSISTIVE
Insights agents
Turn data from every patient in your care programs into population analytics, so your team sees trends across the whole panel.
HOW THEY HAND OFF
From signed order to answer in the chart, with no phone calls.
- Coverage checked The eligibility agent confirms the plan and benefits as soon as the order is signed.
- Rules matched The policy agent finds what this payer needs and checks the chart for it.
- Request filed The submission agent sends it the fastest way the payer accepts. Fax-only payers go to the fax agent.
- Answer written back The auth status agent follows up until a decision and puts it in the chart.
TRUST LADDER
Every agent earns its autonomy at your practice.
Agents start in shadow mode and move up only when your team has seen the results.
STEP 1
Shadow
Agents work every request alongside your team. Nothing is submitted; you compare results.
STEP 2
Assisted
Agents prepare each request; your staff reviews and approves with one click.
STEP 3
Autonomous
Clean requests flow straight through. Your team handles exceptions only.
Works inside your EMR
- Epic
- athenahealth
- eClinicalWorks
- Listed in the athenahealth Marketplace
- X12 278
- FHIR
- Payer portal automation
- Fax
Questions teams ask about the agents
Will this replace our staff?
No. The agents take the repetitive steps: checking coverage, filling in payer forms and following up on status. Your staff review the requests the agents flag and handle the exceptions. [CONFIRM: how current customers have used the time saved]
Do we need to replace our EHR?
No. ColigoMed connects to the EMR you already use through the Data Unifier Hub and writes every result back into it. Your team keeps working in the same screens.
Is this just RPA?
No. Where a payer offers no API, our agents do work the payer’s portal, the way robotic process automation does. The difference is our AI: agents read each screen and payer response and hand anything uncertain to your team. Where payers support X12 278, we submit that way instead, and we are ready to adopt the new payer APIs as they open.
How fast is implementation?
Typically 6 weeks from kickoff to go-live. Agents start in shadow mode, then move to assisted and autonomous only as your team sees the results.