Early access
AI agents for healthcare operations
Less paperwork between patients and care.
Most denials are never appealed — not because they'd lose, but because building an appeal takes hours nobody has. MavenThink agents read the denial and the medical record, draft the appeal, and pin every claim to the exact page that supports it. Your team reviews, signs, and sends. The same discipline runs through prior auth, payer policy monitoring, and the compliance reporting that proves a clinician made every call.
Sound familiar?
- Denials pile up faster than the team can appeal them
- Prior auth packets go out incomplete and come back as denials
- Payer policy changes surface as denials, weeks after the fact
- State rules demand a clinician's final call — and proof of it
What teams automate first
Denial appeals
Agents draft the appeal from the denial reason and the record, with every claim pinned to the source page. Reviewers verify by clicking, not re-reading the chart — then dispatch with their name on it.
Prior authorization
Check whether auth is required, assemble the medical-necessity case with pinned evidence, and catch missing documents before submission — not weeks later as a denial.
Payer policy monitoring
Watch the payers and policies your cases depend on. Changes arrive as alerts with the before-and-after excerpt, linked to the open cases they affect.
Compliance reporting
Human-review rates, override rates, and per-case audit timelines — exportable as attestation reports when someone asks you to prove a person made the calls.
Inside the solution
What you get in the healthcare edition
Enable the solution for your organization and these modules appear alongside the core platform — same roles, same approvals, same audit trail.
Denials Workbench
A queue of denied claims; each case pairs a draft appeal with evidence pinned from the record.
Prior Auth
Requirement checks, necessity summaries, and packet completeness before anything is submitted.
Policy Monitor
Payer policy changes as alerts, linked to the open cases they affect.
Knowledge Packs
Curated coverage rules and terminology, citable by agents like your own documents.
Compliance
Oversight metrics and exportable attestations that decisions carried human sign-off.
Compliance posture
HIPAA-conscious architecture
Tenant isolation, encryption in transit and at rest, and role-based access control aligned with PHI handling requirements.
Clinicians make the final call
No denial, appeal, or submission leaves without human sign-off — the gate is enforced by the platform, which is what a growing number of state AI laws require.
Attestation-ready audit trails
Every case records what was read, drafted, reviewed, and dispatched, by whom — exportable when oversight asks.
Frequently asked questions
How do I know an appeal's claims are actually supported by the record?
Every substantive claim in a draft carries an evidence pin — a link to the exact page and region of the medical record it came from. Reviewers verify by clicking the pin and seeing the highlighted source, so signing an appeal doesn't mean re-reading the chart.
Does the AI ever make a clinical or coverage decision on its own?
No, and there is no setting that changes this. Drafts wait for a person to approve, revise, or dispatch them. Several states now require that no coverage decision be made by AI alone — here that isn't a compliance checkbox, it's how the product works.
Can it handle scanned and faxed documents?
Yes. Enterprise OCR reads scans and faxes, extraction interprets context rather than fixed layouts, and low-confidence fields are flagged for human review instead of guessed.
How much integration does it take to start?
The denials workbench works document-in, letter-out: upload the denial and the record, review the draft, send the appeal. No EHR or payer integration is required on day one — deeper connections can come later.