AI Automation Platform Built for Home Health Operations

Referral Processing

Referrals arriving by fax or portal are retrieved automatically. AI-powered OCR reads the facesheet and attached documents, extracts patient demographics, insurance details, diagnosis codes, episode dates, and referring physician information — and flags missing fields before they cause problems downstream.

Patient Record Creation

Patient demographics, primary and secondary insurance, MBI, Medicaid ID, referring physician NPI, admission type, episode start date, and emergency contacts are entered directly into your EHR — pulled from referral documents, validated, and checked for duplicate records before creation.

Order & Task Setup at Admission

CMS 485, Start of Care order, initial Physician Order, Consent task, and Medication Profile task are generated automatically at admission — with correct episode dates and assignments. Nothing is created manually, nothing is missed.

Physician Order Classification

Incoming physician order faxes — which often contain multiple order types in one document — are split and each order identified individually. CMS 485, Frequency, Recertification, Supply, PRN, and Evaluation orders are each routed to the correct patient episode automatically.

Physician Signature Verification

Every incoming order is checked for a valid physician signature — both digital and handwritten. Orders without a confirmed signature are flagged and held from the EHR until resolved. Nothing unsigned enters the system undetected.

Outbound Order Faxing for Signature 

Orders pending physician signature are automatically faxed to the physician's office with a generated cover sheet. Order status updates when the signed version is received. The follow-up loop runs without manual management.

EVV Exception Processing 

EVV exceptions are processed automatically — the correct reason code is selected, the standardized explanation is entered, and the transaction is resubmitted. Staff only reviews exceptions that fall outside standard patterns.

Clinical Documentation Upload 

Wound images, consent forms, and clinical photographs sent through Slack are uploaded directly to the correct task in the correct patient episode in your EHR — no manual download, no navigation, no risk of wrong-patient upload.

Prior Authorization Tracking 

Open prior authorizations are monitored against payer portals continuously. Status updates are captured automatically, staff are notified when a response requires action, and upcoming expirations are flagged before a coverage gap occurs.

Insurance Claim Status Tracking 

Claim status is checked in bulk across Medicare, Medicaid, and commercial payer portals. Payment status, denial reasons, and check numbers are retrieved automatically and updated in your tracking system — no manual portal logins.

Denial Reason Logging 

Every claim denial reason is logged against the associated patient record and order history — giving your billing team the visibility to identify which upstream documentation or authorization issue is generating repeated denials.

After-Hours Call Handling 

Patient and caregiver calls outside business hours — visit scheduling, rescheduling, messages to care coordinators — are handled by conversational AI. Every call is captured with structured detail and routed to the right person. No calls are lost to voicemail.

Exception Handling & Human Handoff 

When the platform encounters a document it cannot process with confidence — degraded fax quality, unrecognized order type, patient record conflict — it flags the item and notifies the right staff member with the context already captured. Humans handle the exceptions; the platform handles the volume.

Audit Trail & Compliance Logging 

Every action the platform takes is logged with a timestamp and full detail — document processed, data extracted, fields entered, order uploaded. Audit-ready records are maintained automatically for every automated action.