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AI PAYER FOLLOW UP ENGINE

Stop chasing payers.
Start closing claims.

AI payer follow-up software that executes calls, navigates IVR systems, checks portals, and pushes structured claim status back into your RCM workflow. Built for supervised automation and full auditability.

Consult Our Experts
AI-Driven
Claim Follow-Up
Real-Time
Status Retrieval
Automated
Payer Coordination
AI-Powered
AR Recovery
TRUSTED BY
CVS Health DENmaar Perinatal Access Presidium Health Five Star Voi Home Health Pro Synergy Health Partners TAPiT

RCM isn’t broken because teams can’t see the problem. It’s broken because nothing acts on it.

Claims over 30, 60, 90 days sit untouched because no one can get to them fast enough. Staff burn hours on hold waiting for payer reps who never pick up. Portal logins eat up half the morning — switching between systems, re-entering credentials, searching claim after claim. And when status finally comes back, it's unstructured, incomplete, and buried in notes no one acts on.

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27%
Claims sit unresolved in A/R

Billing teams drown in queues. Claims age. Cash slips through the cracks while dashboards show the damage after it’s done. Claims follow-up automation eliminates this entirely. 

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14 days
Average lag on payer follow-ups

Manual status checks can’t keep pace with payer cycles. Every idle day is revenue aging into risk. The only fix is to reduce manual payer follow-up entirely. 

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80%+
Of follow-ups still done manually

Hours spent on hold, logging into portals, and re-entering status — the exact workload that AI is built to reduce manual payer follow-up from.

End-to-End Payer Follow-Up, Handled Entirely by AI

The Engine isn’t a layer on top of your RCM stack. It’s the operator inside it — autonomously processing claims, reading signals, contacting payers, and capturing structured status outcomes your team shouldn’t have to chase.

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Ingests claims requiring follow-up directly from your RCM system for autonomous claims processing.

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Prioritizes claims by aging and workflow logic — highest risk worked first.

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Executes autonomous payer calls without any manual effort.

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Automates payer IVR navigation — pressing prompts, entering medical claim numbers, retrieving status.

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Checks payer portals for current status on every claim it tracks.

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Captures structured outcomes and pushes next actions back into your workflow.

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Traditional RCM Dashboards

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Shows you what went wrong

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Alerts that pile up in queues

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Requires manual payer follow-up

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Analytics after the fact

AI Revenue Engine

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Executes the next follow-up step on its own

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Acts on stalled claims in real time

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Runs payer calls and portals end-to-end

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Delivers structured claim status every time

AI Workflows for Automated Payer Follow-Up

Purpose-built AI workflows designed to automate payer outreach, claim status retrieval, and follow-up execution across healthcare revenue cycle operations.

AI Payer Follow-Up

Executes outbound payer calls, navigates IVR systems, and checks portals in parallel to retrieve structured claim status updates automatically.

Outcome & Workflow Management

Records payer interactions and pushes structured status updates, next actions, and follow-up outcomes back into the RCM workflow automatically.

EHR & Payer Connectivity

Connects with EHRs, billing systems, clearinghouses, and payer platforms through APIs and workflow synchronization without replacing existing infrastructure.

EHR-Payer-Connect

AI Agents Built for Revenue Cycle Teams

RCM Revenue Engine Dashboard
4x Faster Denial Resolution with AI
5x Reduction in Denial Management Workload

Stop Writing Off Denied Claims. Start Recovering Them.

OSP's RCM Revenue Engine pulls denied claims from any source — EHR, clearinghouse, or manual upload — uses AI to identify the root cause, determines the best course of action, and automates the entire resolution workflow.

What It Does

  • Identifies root cause of every denial using AI
  • Auto-generates appeal letters tailored to payer requirements
  • Resubmits claims or routes complex cases to staff
  • Tracks every denial from identification to resolution
See It In Action
Claims Scrubbing Dashboard
95%+ First-Pass Clean Claim Rate
50% Reduction in Manual Claim Review

Every Claim Scrubbed Before It Leaves Your Office.

OSP's AI Claims Scrubbing Agent validates every claim before submission — checking coding accuracy, payer rules, NCCI edits, and eligibility in real time. It catches the errors, suggests the fixes, and routes clean claims to the payer.

What It Does

  • Automatically validates CPT, ICD-10, and HCPCS codes against payer-specific rules
  • Catches coding errors, missing modifiers, and bundling violations before submission
  • Verifies patient eligibility, prior auth, and COB in real time
  • Routes clean claims to payer and flags dirty claims with specific fix instructions
See It In Action

Real Numbers from Teams Using the AI Revenue Engine

Measurable lift in follow-up execution and team capacity within the first operational cycle.

40–60%
Reduction in manual follow-up effort
90%+
Actionable claim status accuracy
80–90%
Routine status checks automated
5–10d
Faster claim resolution cycles

Built to Work with Epic, Cerner, AthenaHealth, and 130+ Payers

API and data-sync native. No disruptive replacement. No clinical downtime. Connects in days, not months. Built natively for Epic claims automation and AthenaHealth billing automation, no middleware, no disruption, no rip-and-replace.

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We integrate directly with your existing healthcare infrastructure so AI workflows operate inside the platforms your teams already use every day.

Your Existing Ecosystem
EHR & Billing Systems
Clearinghouses & Claims Infrastructure
Payer Portals & IVR Systems
Revenue Cycle Operations
Follow-Up & A/R Work Queues
Claims Engine
AI Revenue Engine
Autonomous Claim Prioritization
Automated Payer Calls & IVR Navigation
Real-Time Claim Status Retrieval
Structured Workflow Updates
Continuous Follow-Up Execution

Solutions We Delivered

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Mental Health PM+RCM Solution

Built a customized solution to improve revenue cycle and practice management workflows in a mental-health center.

55%

reduction in claims losses

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View Case Study
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Transforming Billing for FQHC Clinics

Developed a secure, HIPAA-compliant claims management platform to automate billing, coding, reimbursement workflows, and denial tracking for a dental FQHC clinic.

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KEY BILLING OUTCOMES IMPROVED

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View Case Study
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Automated Claim Review System

Developed an automated and cloud-based claim review system to identify errors and avoid long turn-around time. Patient authorization, Pokitdot APIs, and claim scrubbing based on Aetna guidelines helped them to enhance the claim processing workflow.

100%

Error-free EORs

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View Case Study
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Advanced RPM With Telehealth

Integrated advanced RPM with telehealth and chatbot capabilities to improve chronic care and real-time tracking of patients.

60%

of patients reported a better overall experience

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View Case Study
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Suicide Risk Assessment and Prevention Software

Developed RPA-powered diagnostic tool to prevent suicide risks in veterans and foster clinical decision-making.

50%

improvement in diagnostic accuracy

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View Case Study
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Senior Home Care Management Solution

Developed a digital home care solution that improves patient-provider communication, remote care and care coordination.

50%

greater accuracy in health assessment

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View Case Study

Works With What You Already Use

Epic HL7 CDA Athena Health Meditech eclinicWorks next gen Microsoft Microsoft Epic HL7 CDA Athena Health Meditech eclinicWorks next gen Microsoft Microsoft
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For the teams running real revenue cycles.

Best fit: organizations managing 10,000+ claims per month who need consistent, scalable payer follow-up execution to reduce AR days in healthcare without adding headcount.

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RCM Firms & Billing Companies

Run more books with the same headcount. The Engine handles the payer follow-up work your analysts repeat every day — plugged into your existing tech stack.

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High-Volume Providers & Multi-Location Groups

Scale follow-up throughput without scaling billing teams. Ideal for group practices, specialty chains, and hospital networks.

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Provider Revenue Cycle Teams

Reduce follow-up backlog, improve execution consistency, and relieve A/R pressure — without adding headcount.

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Hear From Our Clients

comma

We've reached out and found companies like OSP to create our technology. This is my first time working with a company that has been so thorough. These guys are amazing. If you really are looking for someone for a technology solution, these guys are the real deal.

Author
Stephen Carter
Co-Founder Home Health Pro
comma

We approached OSP for a technology solution estimate and were impressed by their professionalism and clarity. Confident in their approach, we moved forward quickly. Their team stayed on schedule and within budget, providing regular updates. For future development needs, OSP will be our first choice.

Author
Selita Jansen
Vice President Operations Health Solutions, LLC
comma

Voi is dedicated to ending suicides globally with two solutions: Voi Detect, a validated suicide risk assessment, and Voi Reach, an AI-driven support app. OSP played a crucial role in transforming our concepts into commercially successful, award-winning solutions. I sincerely appreciate their invaluable support.

Author
Rick Johnson
CEO, Voi Health

Frequently Asked Questions

How do we automate payer follow-up without adding more personnel?

OSP’s AI Revenue Engine automates follow-up with payers by handling calls, IVR paths and checking the portals on its own. This reduces the amount of time spent on manual payer follow-up by 40-60%. Your team can then concentrate on resolving issues instead of continuously chasing down the status of your claims – requiring no additional staff to accomplish this.

Agentic AI in RCM is actually agentic AI is the use of fully autonomous software applications to process electronic healthcare claims in RCM. This software will independently ingest an electronic claim and complete all processes; including contacting the payer for claim status updates and updating the claim workflow – without any human intervention. Agentic AIs also continuously act upon all claims in the RCM process at all times, not merely provide passive dashboards of the status of individual claims.

Yes. OSP’s Engine executes outbound payer calls and automates payer IVR navigation pressing prompts, entering claim numbers, and retrieving automated claim status checks without any human on the line. Hence no hold time and no agent required.

Claims follow-up automation lets billing companies run more client accounts without growing headcount. Healthcare collections automation will be able to do everything from payer calls to IVRs and portals for every claim without increasing costs.

OSP aims at upstream claim status follow-up by using automated claim status verification, which will ensure that any payer response is captured early on, to prevent things from getting out of hand.

Reducing AR days in healthcare requires faster payer follow-up execution. Healthcare collections automation eliminates the 14-day average lag on manual status checks continuously chasing claims across calls, IVR, and portals so aging buckets shrink faster.

Yes. Payer portal automation retrieves automated claim status checks from payer web portals continuously no manual login, no manual search, no repetitive data entry. Status is always current and pushed directly back into your RCM workflow.

The OSP AI Revenue Engine is built for Epic claims automation, it integrates with Epic via two-way API integration and is thus well suited for automating claims follow-ups since it communicates directly without the need for any middleware technology or changes to existing systems. The engine retrieves claims data from Epic, performs follow-ups, and then places the structure back into Epic.

Healthcare collections using AI can be automated and work continuously, where they are not fatigued, or have any hold times, or have costs per claim. Additionally, it can be scaled immediately, will continue to perform consistent automated claims status checks, and would send structured claims status information back at a significantly lower cost than using outside service contractors. 

AI revenue cycle software automates claim intake, autonomous claims processing, payer calls, IVR navigation, portal checks, and outcome capture today. Claims follow-up automation handles the entire payer contact cycle structured status delivered without manual intervention.

Ready to automate your payer follow-up?

Tell us about your RCM stack and current follow-up volumes. We'll show you how the Engine runs healthcare collections automation on your claims — and scope a deployment in under 30 minutes.

30-minute live walkthrough using your claim types and payer mix

ROI estimate based on your current follow-up volume and team size

Integration plan for your existing RCM and EHR stack

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