Claims
Prepare cleaner claim worklists and missing-detail checks.
AI agents for the RCM work that slows teams down.
Specialized agents support eligibility, coding review, claim prep, denials, EOB posting, and payer-call follow-up.
Eligibility agent
Coding specialist
Claims prep
Denials
Payer calls
Each repetitive task gets a clear queue.
Agents organize the work around the job to be done, so teams know what needs review, what needs payer follow-up, and what is ready to move.
Eligibility
Check coverage and benefits before the visit becomes claim friction.
Coding
Surface CPT, ICD, modifier, and documentation review items.
Denials
Organize appeals, payer responses, and resubmission work.
EOB posting
Keep remittance review and payment posting visible.
Payer calls
Support phone-heavy follow-up when portals are not enough.
Agent layer
More than one bot. A work queue for each revenue bottleneck.
YULY Agents are organized around revenue-cycle jobs: coverage discovery, claim readiness, denials, EOB conversion, A/R leakage, and payer follow-up. The goal is to make the work visible, reviewable, and easier to assign.
Eligibility and benefits
Coverage Discovery Agent
Finds active coverage signals, COB details, subscriber mismatches, and benefit information before the claim becomes a billing problem.
Runs eligibility and COB checks for new or returning patients
Works even when card data or secondary coverage is incomplete
Feeds updated subscriber and patient details into claim prep
Cleaner first submission
Claim Readiness Agent
Compares claim details against documentation, eligibility, coding support, custom rules, and payer requirements so more issues are caught before submission.
Checks formatting, coverage, coding, and documentation dependencies
Highlights payer-specific rules and practice-specific edits
Helps teams move toward stronger first-pass acceptance
AR recovery
Denials and Appeals Agent
Turns denials into structured next steps by reading claim history, remittance context, note support, and payer feedback.
Identifies the likely denial driver from claim and remittance data
Prepares corrected-claim and appeal work queues
Escalates payer follow-up when portal or phone work is needed
Payment posting
EOB Conversion Agent
Converts paper scans, PDFs, and image-based EOBs into reviewable remittance and posting workflows without building a large manual processing line.
Handles scanned, PDF, and imperfect image inputs
Extracts payment, adjustment, and denial details for review
Moves remittance data into posting and follow-up queues
Leakage prevention
A/R Protection Agent
Watches for underpayments, missed reimbursement opportunities, claim errors, and avoidable write-offs across payer and historical claim patterns.
Flags payer contract and payment variance patterns
Surfaces recoverable A/R opportunities
Connects leakage signals back to claims and denials
Phone and portal work
Payer Follow-Up Agent
Organizes payer-call follow-up, missing information requests, and unresolved claim tasks so staff-heavy work does not disappear between systems.
Creates follow-up tasks from payer responses
Keeps calls, portals, and claim status together
Routes unresolved items to the right worklist
See YULY Agents in context.
Talk with sales about how this product fits with the full YULY platform.