One system of record. AI on every step of it.

Every fax, upload and e-prescription is read, split into patient packets, classified and routed before anyone opens it. Patient work goes to intake; remittances go to Payments; replies to our own document requests land on the item that asked.

Boundary. A page the AI cannot prove is held for a person. Nothing is guessed from a member ID or a birth date alone.

The agent phones the payer, navigates the IVR, asks the eligibility, benefit, claim-status or authorization question and records the answer with the reference number and the representative's name.

Boundary. A phone answer is evidence, not a verdict. It is filed on the patient record; it never changes a claim status or a balance.

Patients due for CPAP and other resupply get a recorded call that confirms what they need, where to ship it and how they would like to be contacted.

Boundary. Only a clear yes or no is written down. An unanswered question is never stored as a no. A patient who asks not to be called is never called again.

277 acknowledgements, 835 remittances, the clearinghouse queue and the ledger are read in one order of precedence and shown as one answer on every claim, with a tracker that checks off what a scan reliably established.

Boundary. The absence of data is never presented as an answer. A claim we have not billed is never shown as awaiting the payer.

Remittances post to the service line they belong to, with every adjustment classified by one shared rule across the fleet. Paper EOBs dropped into the inbox become batches on their own.

Boundary. Posted cash is never deleted or mass-restated. A payment the matcher cannot place is parked and shown, never dropped.

Ask a question in plain English and get a table. Ask for a report and an agent plans it, runs the queries and returns KPIs, charts, tables and caveats.

Boundary. Every number on the report is computed by the same semantic layer the A/R report uses. The model never types a figure.

Signed orders come back by fax, portal or email and are matched to the right prescription by a printed return code, then marked signed and complete.

Boundary. No code, no match. A document that could belong to two prescriptions goes to a person. A signed document is never altered or buried.

Missing documentation is requested from the ordering physician automatically, by fax or email, once the practice authorizes it.

Boundary. One request per patient, doctor and issue in 72 hours. Hard caps per destination and per hour. A storm is stopped by the database, not by hoping.