An AI agent for every stage of the revenue cycle.
Five Claira Health agents do the routine work first, from the booking to the last payment. A person sees only what an agent could not finish, with the reason in plain words.
The agents are being built now and shown on made-up patients. None is live with a clinic yet.
Seven stages, five agents
Read across for an agent’s job, or down for everything that happens at one stage. The stages are the claim journey Claira Health follows.
| Agent | 01Book appointment | 02Coverage check | 03Collect from patient | 04Submit claim | 05Denials review | 06Appeal and resubmit | 07AR follow-up |
|---|---|---|---|---|---|---|---|
| ScoutInsurance found and confirmed | Finds the patient’s insurance when none is on file, and asks for a card photo | Confirms the insurance is active on the day of the visit, and re-checks the day before | Works out the patient’s estimated share for every booked visit and sends it; a good-faith estimate for self-pay | · | · | · | · |
| AssentApprovals and referrals in hand | · | Finds which services need the insurer’s approval or a referral, and gets them before the visit | · | · | Works the denials for a missing or wrong approval or referral | Sends the corrected claim, extension, late approval or appeal | · |
| DispatchStrong claims, on time | · | · | · | Verifies and scores the suggested codes (the confidence meter decides when a person looks), builds the claim on the evidence every earlier agent gathered, fixes the mechanical mistakes, and sends it inside its filing limit | · | · | · |
| ChartThe clinical record, at every stage | · | Drafts a pre-visit note: what to assess and record for this insurer | · | Drafts the visit note and the wrap-up for the clinician to sign, and suggests the codes from the signed note | · | Its signed notes are the evidence an appeal cites | · |
| ReclaimEvery unpaid claim, until it is paid | · | · | Raises earlier balances at check-in and offers payment plans; the front desk collects | · | Bills the right insurer, closes duplicates, supplies missing information | Appeals with the earlier agents’ evidence, asks the clinician or desk for what is missing, and resends at the right level | Chases claims nobody answered, disputes underpayments, squares up the patient’s share after the claim |
| Patient messagingA channel the agents share | Card photo, for Scout | · | What the patient will owe | · | · | · | Payment link and reminders, for Reclaim |
Agents first. People for the exceptions.
No active coverage can be found, or the patient needs to be told.
The chart lacks what the insurer asks for, or a clinician must speak to the insurer.
The confidence meter says a code needs a person, or a fix needs a coding judgement.
Always: the clinician reads, corrects and signs every note, before, at and after the visit.
A clinical denial, a write-off, or a patient who disputes the bill.
Writing money off, the clinician’s own words and the conversation with a patient about money always stay with people.