# Clicks Health > Clicks Health takes over the repetitive work healthcare admin teams complain about, like payer portal checks, prior auth follow-up, denial appeals, and faxed referrals, and does it inside the systems they already use. Clicks Health (also known as Clicks, website clickshealth.com) is a Y Combinator company (Fall 2025) based in San Francisco. It builds AI agents for healthcare revenue cycle and operations teams: RCM companies, orthopedic and specialty practices, rural hospitals, and other operators that still rely on manual, outsourced, or offshore admin work. The agents work the way a trained team member does. They log into the EHR, PM system, payer portals, and carrier portals with the access the customer grants, read charts, faxes, and documents, call payers, and follow the customer's documented SOP. There is no integration project and no new software for staff to learn. Supported systems include Epic, athenahealth, ModMed, NextGen Healthcare, eClinicalWorks, and any other system a team can log into. What stays human: medical necessity and clinical judgment, provider signatures and attestations, coding decisions with compliance accountability, payer relationships, and any exception the customer routes to staff. Agents never add diagnoses; they read what the provider documented. Clicks maps the manual steps, estimates the impact, and automates a selected workflow in 5 weeks or less. Clicks is SOC 2 Type II audited and HIPAA compliant, and every agent action is logged and reviewable. ## Frequently asked questions ### What is Clicks Health? Clicks Health gives revenue cycle and healthcare operations teams AI agents to run repetitive work inside the EHRs, PM systems, payer portals, spreadsheets, and internal tools they already use. ### Who is Clicks Health for? Clicks Health is built for RCM companies, orthopedic practices, rural hospitals, and healthcare operators that still rely on manual, outsourced, or offshore revenue cycle work. ### What healthcare workflows can Clicks Health automate? Any repetitive workflow with a documented path and a clear review point. Today that includes eligibility and benefits, prior authorization, claim cleanup, denials and appeals, payment posting, patient credit refunds, payer portal follow-up, credentialing, and FMLA and disability forms. The work is not only on screen: agents call payers for status and authorizations, and they read incoming faxes and send outgoing ones. ### How does Clicks work with payer portals? Clicks receives authorized user access and works through the same payer portal screens your team uses. Agent actions are logged, completed work returns to the queue or person you choose, and exceptions can pause for human review. ### How does Clicks Health help specialty groups? Specialty groups carry the heaviest payer paperwork per visit: prior authorization, state-specific forms, and appeals on top of normal billing. Clicks gives them agent capacity for that work inside the EHR and PM system they already run. No system replacement, no integration project, and exceptions still come back to staff. ### How fast can Clicks Health automate a workflow? Clicks maps the manual steps, estimates the impact, and automates the selected workflow in 5 weeks or less, with the right controls in place. ### What repetitive healthcare admin work can AI agents take over? Any repetitive workflow with a documented path and a clear review point. Clicks Health agents take over claim status checks in payer portals, prior auth follow-up, faxed referral entry, denial appeals, eligibility checks, payment posting, patient credit refunds, payer and state forms, and workers' comp claim verification. ### Do AI agents replace healthcare admin staff? No. Clicks Health agents take the repetitive path, and your team keeps the judgment calls: medical necessity, provider signatures, payer escalations, and every exception you route to a person. Every agent action is logged and reviewable. ### How long does it take to hand off one workflow? Clicks Health maps the manual steps, estimates the impact, and automates the selected workflow in 5 weeks or less. There is no integration project, because the agents work inside the EHR, PM system, and portals your team already uses. ## Referral intake Source: https://clickshealth.com/solutions/referral-intake ### What is referral intake automation? Referral intake automation means receiving, reading, screening, and verifying an incoming referral without a coordinator doing it by hand. Clicks is not another piece of referral software for your team to log into. It is an agent that works your EHR, payer portals, and carrier portals directly, doing the same steps a coordinator would. ### How does Clicks handle orthopedic referral intake? Clicks already runs orthopedic referral intake for provider groups across the US. The three most common workflows are: verifying workers' compensation and PIP referrals with the carrier, which means confirming the claim, identifying the adjuster, and checking which body parts are authorized; completing prior authorization packets and the state-specific forms each payer requires, such as the New Jersey APTP on personal injury protection claims; and capturing referrals from eFax and portals into the EHR with acceptance screening and urgency triage applied on arrival. ### Does Clicks work for orthopedic practices with high workers' compensation volume? That is the case Clicks is strongest on. Orthopedic and spine practices carry a heavy workers' compensation and personal injury share, and those referrals are the ones that get written off: the claim has to be confirmed, the current adjuster found, and the authorized body parts checked before anyone schedules. A referral for a shoulder against a claim that only covers the lumbar spine is caught before the visit rather than after the denial. Pain management, physical therapy, and occupational medicine groups run the same workflow. ### Can Clicks put orthopedic referrals straight into Epic, athenahealth, or ModMed? Yes. The agent works your EHR the way a coordinator does, so referrals are captured from eFax, portals, and email and written in as clean patient records. Epic, athenahealth, ModMed, NextGen Healthcare, and eClinicalWorks are all in scope, and so is any other system your team can log into. No integration project or data migration is required. ### Can Clicks read faxed referrals? Yes. Clicks agents pull referrals from eFax, payer and carrier portals, and email, read the document, extract the clinical and demographic details, and write a clean record into the EHR. The same agent follows up with the referring office when imaging, operative notes, or a signed authorization is missing. ### Does Clicks verify workers' compensation claims on referrals? Yes, with any carrier or third-party administrator. The agent logs into whichever system holds the claim, Sedgwick, Gallagher Bassett, CorVel, The Hartford and Enlyte among them, to confirm the claim is active, identify the current adjuster and contact details, and confirm the authorized body parts and procedures. If your team can reach a carrier's portal, so can the agent. ### How does Clicks triage referrals by urgency? There is no queue. Every referral is processed the moment it arrives, and the agent works as many at once as you send it, so a spike in volume does not slow anything down. Each referral is still screened against your acceptance criteria and labeled by clinical urgency so your team can see what needs attention first, and ineligible referrals are routed to staff as tasks. Your team sets the criteria and keeps every urgency override. ### Does Clicks call and schedule referred patients? Not today. Clicks does operate voice agents, but patient outreach is not part of the referral intake workflow. The agent does the file work ahead of scheduling: reading the referral, verifying coverage and authorization, preparing the chart, and updating referring offices, adjusters, and employers. The patient conversation stays with your team. ## Prior auth submission Source: https://clickshealth.com/solutions/prior-auth-submission Your coordinators know the case in minutes. Typing it into the payer's portal, form or phone line takes the rest. A Clicks agent builds the request from the chart, submits it wherever the payer wants it, and logs the confirmation back in the EHR. ### Which payers and portals does it work with? Any portal, form or phone line your team can use, including Availity, eviCore and Carelon, and state forms such as the New Jersey APTP. When a payer changes its routing, the agent adapts. Your team does not have to. ### Does the agent decide medical necessity? No. The provider decides what the patient needs before the agent starts. The agent works from what the provider documented and never adds a diagnosis. ### Which EHRs does prior auth submission work in? eClinicalWorks, athenahealth, ModMed, Epic, NextGen Healthcare, and any other system your team can log into. The agent works the same screens your coordinators use, so there is no integration project. ### What if the payer asks for something that is not in the chart? The agent sends the case to your team with exactly what is missing. It does not guess, and it does not create documentation. ### Does it follow up after submission? Yes. The agent checks status on a schedule, calls when the portal has no answer, and sends the records the payer asks for until the decision lands. ## E&M coding review Source: https://clickshealth.com/solutions/em-coding-review Your scribes code the visit. A Clicks agent reads every note before the nightly batch, fixes the modifiers, side, and pointers your billers would catch, and holds anything unclear with a note. ### Does Clicks replace our scribes or billers? No. Scribes still code during the visit and billers keep the final say. The agent does the second look before the claim goes out and hands your billers only the visits that need a decision. ### Which EHRs does E&M coding review work in? eClinicalWorks, athenahealth, ModMed, Epic, NextGen Healthcare, and any other system your team can log into. The agent works the same screens your billers use, so there is no integration project or data migration. ### How do we know the agent codes correctly? During the pilot your billers check every encounter the agent reviewed. We report how often the agent's coding matched theirs and go through every mismatch with you, so you see accuracy on your own visits before anything runs on its own. ### What happens when the note and the codes disagree? The agent holds the claim, writes a billing note that says what it found, and adds a tip for the scribe. It does not guess. Your billers decide, and the claim moves on. ### Can the agent give feedback to our scribes? Yes. Every held claim comes with a short note on what was missing from the documentation, such as the side of an injection or the X-ray findings, which you can pass on to the scribe. ## Insurance and demographics checks Source: https://clickshealth.com/solutions/eligibility-verification Every night, a Clicks agent checks tomorrow's schedule with each payer, catches plans that changed, confirms demographics, and adds the copay to the appointment. Your front desk only handles what needs a person. ### Does this replace the eligibility check in our EHR? No, it builds on it. Many EHRs send a basic eligibility request. The agent goes further: it reads the payer portal when the response is unclear, searches for active coverage when a plan lapsed, compares demographics with the payer's record, and writes the result to the appointment. ### Which EHRs and payers does it work with? athenahealth, eClinicalWorks, Epic, ModMed, NextGen Healthcare, and any other system your team can log into, along with payer portals and clearinghouses such as Availity. No integration project is required. ### When do the checks run? Whenever you choose. Most teams run them overnight for the next day's schedule, and a few days ahead for new patients, so the front desk starts the morning with a checked schedule. ### Does the agent change our records? Only within the rules you set. Your team decides which changes the agent makes on its own, such as member ID and address corrections or plan updates, and which go to the front desk for review. Every change is logged. ### What happens when no active coverage is found? The patient goes on the front desk worklist with what the agent checked and the next step, such as calling the patient for new insurance details before the visit. ## Repetitive work Clicks takes over ## Stop checking claim status in payer portals by hand Source: https://clickshealth.com/repetitive-work/payer-portal-claim-status-checks Someone on your team spends the morning logging into one payer portal after another to see which claims moved. Clicks agents do the checking in the same portals and send back only the claims that need a person. Claim status work looks the same in almost every billing office. Open the aging report, log into the payer portal, search the claim, read the status, write a note in the PM system, then move to the next payer with a different login and a different screen. None of it is hard. It is just endless. Most claims are moving fine, so most of the clicking confirms what nobody needed to know, while the claims that actually stalled wait until someone gets to them. ### Why the queue never shrinks - Every payer works differently: Each portal has its own login, search screen, and status codes, so the work never gets faster with practice. - Most checks find nothing: Staff spend the most time on claims that are fine, and the stuck ones surface late. - Status lives outside the PM system: Results are copied back by hand, or the next person checks the same claim again. ### Clicks handles - Pulls the claims due for follow-up from your aging report or work queue - Reads status, remark codes, and requested documents in each payer portal - Calls the payer when the portal has no answer - Writes the status and next action back into your PM system - Routes denied, pended, and stuck claims to the right person with context attached ### Your team keeps - Escalations with payer representatives - Corrected claim and resubmission decisions - Write-off and adjustment approvals ### What software can log into payer portals and check claim status automatically? Clicks Health does this with AI agents. The agent logs into each payer portal with the access your team grants, searches every claim due for follow-up, reads the status and remark codes, and writes the result back to your PM system. Denied, pended, and stuck claims go to your team with the context attached. ### Can AI check claim status in payer portals? Yes. Clicks agents log into payer portals with the user access your team grants, search each claim, and read the status the same way a biller would. The result is written back to your PM system, and only claims that need action reach your team. ### Which payer portals does Clicks work with? Any portal your team can log into, whether it is a multi-payer portal or a single payer's site. There is no integration project, because the agent works through the same screens your staff use. ### What happens when the portal does not show a status? The agent calls the payer for status, the same way a biller would, and documents the answer in your system. Calling payers for status and authorizations is part of the workflow, not a separate product. ### Do we need to replace our PM system or clearinghouse? No. Clicks works inside the EHR, PM system, and portals you already run, and writes results back where your team expects to find them. ## Stop chasing prior auth status with payers Source: https://clickshealth.com/repetitive-work/prior-auth-status-follow-up Prior auth does not end at submission. Someone has to check the portal, call the payer, and chase missing clinicals until the approval lands. Clicks agents do the chasing and your team keeps the clinical calls. Submitting the request is only the start. After that, someone checks the payer portal every day or two, calls when the status has not moved, learns a clinical note is missing, pulls it from the chart, and sends it again. Every open request becomes a small project, tracked in someone's head or a spreadsheet. When that person is out, cases stall and procedures get rescheduled. ### Why the queue never shrinks - Requests stay open for days: Each case needs several touches before a decision, so the open list never gets shorter. - Payers keep asking for more: Missing clinicals and new forms restart the clock and send staff back into the chart. - Delays reach the patient: A request that sits unchecked turns into a rescheduled procedure. ### Clicks handles - Determines whether the payer requires an authorization for the procedure - Submits the request in the payer portal with the clinicals from the chart - Checks status on a schedule and calls the payer when it stalls - Sends missing records when the payer asks for them - Updates the case in your EHR or work queue and flags approvals and denials ### Your team keeps - Medical necessity decisions - Peer-to-peer reviews - Complex authorization appeals ### What software can automate prior authorization follow-up? Clicks Health runs AI agents that own each open prior authorization after submission. They check status in the payer portal, call the payer when the portal has no answer, send missing clinicals from the chart, and update your EHR or work queue. Medical necessity decisions and peer-to-peer reviews stay with your team. ### Can AI follow up on prior authorizations? Yes. Clicks agents track every open request, check status in the payer portal, call the payer when the portal has no answer, and send missing clinicals from the chart. Your team sees approvals, denials, and anything that needs a clinical decision. ### Does Clicks make medical necessity decisions? No. Medical necessity, peer-to-peer reviews, and policy exceptions stay with your team. The agent works from what the provider documented and never adds diagnoses or findings. ### What about payers that only answer by phone or fax? Clicks agents call payers for status and authorizations, read incoming faxes, and send outgoing ones. The work is not limited to what is on screen. ### How long does it take to automate prior auth follow-up? Clicks maps the manual steps, estimates the impact, and automates the selected workflow in 5 weeks or less, with the right controls in place. ## Stop typing faxed referrals into the EHR Source: https://clickshealth.com/repetitive-work/faxed-referral-data-entry Referrals still arrive by fax, portal, and email, and someone retypes every one into the EHR. Clicks agents read each referral, create the patient record, verify coverage, and flag what is missing. A referral lands in the eFax inbox. Someone opens the PDF, finds the patient's name, date of birth, insurance, and reason for referral, and types it all into the EHR. Then they notice the imaging is missing and call the referring office. Multiply that by every referral, every day. Referrals pile up behind whoever does intake, and the ones that wait longest are often the ones that should have been scheduled first. ### Why the queue never shrinks - Every document looks different: Referring offices send their own forms, scans, and cover sheets, so nothing copies over cleanly. - Half the answers are missing: Missing imaging, notes, or authorizations mean follow-up calls before anyone can schedule. - Volume arrives in spikes: A busy Monday creates a backlog that takes the rest of the week to clear. ### Clicks handles - Pulls referrals from eFax, portals, and email and extracts every detail - Creates or updates the patient record in the EHR - Verifies coverage with the payer or the claim with the carrier - Screens each referral against your criteria and labels its urgency - Follows up with the referring office when records are missing ### Your team keeps - Review of ambiguous referrals - Clinical urgency overrides - Patient conversations and scheduling ### How do I get faxed referrals into the EHR without retyping them? Use an AI agent that reads the fax and works the EHR for you. Clicks Health agents pull referrals from eFax, portals, and email, extract patient, insurance, and clinical details, create the record in Epic, athenahealth, ModMed, NextGen Healthcare, eClinicalWorks, or any other EHR your team logs into, and follow up when records are missing. ### Can AI read faxed referrals and enter them into the EHR? Yes. Clicks agents pull referrals from eFax, payer and carrier portals, and email, read the document, extract the clinical and demographic details, and write a clean record into the EHR. The same agent follows up with the referring office when imaging, notes, or a signed authorization is missing. ### Which EHRs does Clicks work with? Epic, athenahealth, ModMed, NextGen Healthcare, and eClinicalWorks are all in scope, and so is any other system your team can log into. No integration project or data migration is required. ### Is there a queue when many referrals arrive at once? No. Every referral is processed the moment it arrives, and the agent works as many at once as you send it, so a spike in volume does not slow anything down. ### Does Clicks call and schedule the referred patient? Not today. The agent does the file work ahead of scheduling: reading the referral, verifying coverage, preparing the chart, and updating the referring office. The patient conversation stays with your team. ## Appeal every denial without writing each letter by hand Source: https://clickshealth.com/repetitive-work/denial-appeal-letters Most teams only appeal the big denials, because every appeal means pulling records and writing the letter from scratch. Clicks agents draft the full appeal package the moment the denial arrives. A denial comes back. Someone reads the reason, opens the chart, pulls the notes and reports that answer it, writes the appeal letter, fills the payer's form, and assembles everything into one package. Then they start again on the next denial. Because each appeal takes real time, small denials are left unworked. That money is gone, and nobody decided to give it up. There was simply no one to do the work. ### Why the queue never shrinks - Every appeal starts from scratch: Records, letter, and payer form are assembled by hand for each denial. - Small denials get written off: When time is short, only high-dollar denials are appealed. - Deadlines run out quietly: Appeal windows close while denials wait in the queue. ### Clicks handles - Reads the denial and categorizes the reason - Pulls the clinical records that answer the denial from the chart - Drafts the letter, fills the payer's form, and assembles the package - Tracks appeal deadlines and escalates before they close - Reports denial trends by payer and root cause ### Your team keeps - Review of each package before it goes out - Complex appeal strategy - Peer-to-peer reviews Proof: Win 50% more appeals at 1/4 the cost. An orthopedics group went from 25 to 40 minutes of work per appeal to about 5, and now appeals every denial. Measured over the first two months and 160 appeals. (https://clickshealth.com/customers/aptp-denial-appeals) ### What is the best way to automate denial appeals? Draft the full appeal package as soon as the denial arrives, then have a person review it. Clicks Health agents read the denial, pull the records that answer it, write the letter, fill the payer's form, and track the deadline. An orthopedics group using this wins 50% more appeals at a quarter of the cost, measured over the first two months and 160 appeals. ### Can AI write denial appeal letters? Yes. Clicks agents read the denial, pull the clinical records that answer it, draft the appeal letter, fill the payer's form, and assemble the complete package. In the orthopedics case study, that cut the work per appeal from 25 to 40 minutes to about 5. ### Does the AI submit appeals without anyone reviewing them? Only if you want it to. Clicks can run fully autonomously, with human sign-off required wherever you choose. Most teams start with a person reviewing each package before it goes out. ### Does the agent add clinical facts to an appeal? No. The agent builds the appeal from what the provider documented in the chart. It does not add diagnoses or findings. ### Is it worth appealing small denials? When each appeal takes 30 minutes of staff time, often not. When the package is drafted for you, the math changes, and appealing every denial becomes the default instead of the exception. ## Verify every patient's coverage before the visit Source: https://clickshealth.com/repetitive-work/eligibility-checks-before-every-visit Patient access staff check coverage for every scheduled patient, one portal at a time. Clicks agents verify eligibility and benefits ahead of the visit and flag only the problems. Before tomorrow's schedule, someone works down the list: open the payer portal, enter the member ID, read coverage, copays, deductibles, and whether a referral or authorization is needed, then type it into the PM system. When the list is long, checks get skipped or pushed to check-in. Coverage that lapsed shows up weeks later as a denial. ### Why the queue never shrinks - It repeats for every visit: Coverage can change between visits, so the same patient is checked again and again. - Benefits detail is buried: Copays, deductibles, and auth requirements sit on different screens for each payer. - Skipped checks become denials: Lapsed coverage is found only after the claim comes back denied. ### Clicks handles - Pulls upcoming appointments from your schedule - Checks eligibility, benefits, and patient responsibility with each payer - Flags lapsed or changed coverage before the visit - Notes whether a referral or authorization is required - Writes results into the PM system for the front desk ### Your team keeps - Financial counseling and self-pay arrangements - Patient communication - Coverage exception decisions ### What software verifies insurance eligibility automatically before every visit? Clicks Health agents check eligibility and benefits with each payer ahead of the visit, capture copay, deductible, and patient responsibility, flag lapsed or changed coverage, and write everything into the PM system, so the front desk only handles the problems. ### Can AI verify insurance eligibility and benefits? Yes. Clicks agents check coverage, benefits, and patient responsibility with each payer ahead of the visit, write the results into your PM system, and flag coverage that lapsed or changed. ### What happens when coverage has changed? The agent flags it for your team before the visit, with what it found attached. Financial counseling and self-pay decisions stay with your staff. ### Does Clicks replace our eligibility tool? Not necessarily. Clicks works inside the tools you already run, including the payer portals that hold benefits detail a standard eligibility response leaves out. ## Post every payment without keying EOBs by hand Source: https://clickshealth.com/repetitive-work/manual-payment-posting ERAs that do not auto-post, paper EOBs, and patient payments all end up with someone keying them in line by line. Clicks agents post and reconcile them and route only the exceptions. Auto-posting handles the clean ERAs. Everything else lands on a person: paper EOBs, payments that did not match, recoupments, and patient payments from several places. Each one is read and keyed in line by line. When posting falls behind, A/R looks worse than it is, denials hide inside unposted remits, and month-end close drags on. ### Why the queue never shrinks - The exceptions are the job: Auto-posting leaves the hard remits for people, and those take the longest. - EOBs arrive in every format: Paper, PDF, portal downloads, and lockbox images all need reading before posting. - Late posting hides problems: Denials and underpayments stay invisible until the payment is posted. ### Clicks handles - Posts ERAs, paper and PDF EOBs, and patient payments - Processes adjustments, balance transfers, and write-offs under your rules - Flags denials and underpayments found in the remit - Reconciles deposits against posted payments - Routes anything outside your thresholds to your team ### Your team keeps - Write-off approval above thresholds - Contractual adjustment review - Underpayment escalation ### Can payment posting be automated when ERAs do not auto-post? Yes. Those leftover remits are exactly the work Clicks Health agents take over. They read paper and PDF EOBs, post each line, apply patient payments, process adjustments under your rules, and reconcile deposits. Anything above your thresholds goes to your team. ### Can AI post payments from paper EOBs? Yes. Clicks agents read paper and PDF EOBs, post each line to the right account, and reconcile the deposit, the same way a payment poster would. ### Does Clicks replace our auto-posting? No. Keep what already works. The agent takes the remits your auto-posting leaves behind, which are the ones that take your team the longest. ### Who approves write-offs? Your team. The agent applies write-offs and adjustments under the rules and thresholds you set, and anything above them is routed to a person. ## Clear the patient credit refund backlog Source: https://clickshealth.com/repetitive-work/patient-credit-refunds Every patient credit needs the same careful review across several systems before money goes back. Clicks agents work the review, prepare the refund or transfer, and route exceptions to your team. Before a refund can move, someone checks the EHR, account notes, related encounters, insurance balances, open patient responsibility, bad debt, and prior refunds. Only then do they know whether the credit is real and whether to refund it, transfer it, or leave it alone. The queue does not bring in new revenue, so it loses every priority call to claims and denials. The backlog grows, even though patients are owed the money and clients expect clean credit balances. ### Why the queue never shrinks - A credit is not always a refund: The team has to prove it came from a real patient payment, not an adjustment. - Other balances come first: Open patient responsibility or bad debt on a related encounter may need a transfer instead. - It never feels urgent: Work that gives money back loses to work that brings money in. ### Clicks handles - Finds accounts with patient credit balances - Confirms the credit came from a real patient payment - Checks insurance balances, related encounters, and bad debt - Prepares the refund request or the transfer under your rules - Routes exceptions for review with the account context attached ### Your team keeps - Refund policy and approval thresholds - Refund authorization - Final exception decisions ### How do RCM companies clear a patient credit balance backlog? By automating the review, not the decision. Clicks Health agents confirm each credit came from a real patient payment, check insurance balances and related encounters, and prepare the refund or transfer under the client's rules. Exceptions and approvals stay with the team. ### Can AI process patient credit balance refunds? Yes. Clicks agents follow the same checklist a trained analyst uses: confirm the credit came from a real patient payment, check insurance balances and related encounters, then prepare the refund or transfer. Exceptions are routed to your team with the context already collected. ### Why not use a rules-based bot for refunds? Refunds quickly outgrow if-then logic. The automation has to tell a true patient payment from an adjustment, check related encounters, and decide whether to refund, transfer, exclude, or escalate. That takes reading and judgment, not just clicks. ### How do you roll this out safely? In stages. Start with read-only review and classification, then drafted actions for human approval, then controlled updates for clean accounts, then exception routing with audit-ready notes, and only then a broader rollout. ## Fill every payer and state form from the chart Source: https://clickshealth.com/repetitive-work/payer-and-state-form-filling State forms, payer forms, and FMLA and disability paperwork all mean copying the same chart details onto another PDF. Clicks agents fill each form from the record, and the provider only reviews and signs. A payer or state requires a form: a pre-certification form, an FMLA or disability form, a payer-specific request. Someone opens the chart, finds the diagnosis, dates, orders, and notes, and copies them field by field onto the PDF. None of it needs judgment until the provider signs. But every form takes real time, and forms that wait hold up care, claims, and patients' paperwork with their employers. ### Why the queue never shrinks - Same data, another form: Every form asks for details that already sit in the chart. - Every state and payer differs: Each form has its own fields, rules, and attachments. - Errors come back as denials: A wrong field or a missing attachment sends the request back. ### Clicks handles - Detects when a form is required - Reads diagnosis codes, dates, and orders from the provider's documentation - Fills every field and attaches the supporting records - Places the completed form in the provider's queue for signature - Files the signed form where it needs to go ### Your team keeps - Provider review and signature - Clinical judgment and attestations - Forms with unclear or conflicting documentation Proof: Cut APTP admin to zero with 24% fewer admin denials. An orthopedics group went from roughly 15 minutes of admin per New Jersey APTP form to none. The provider only reviews and signs. (https://clickshealth.com/customers/orthopedics-regulatory-form-automation) ### What software fills out payer and state forms from the EHR? Clicks Health agents fill payer forms, state pre-certification forms like the New Jersey APTP, and FMLA and disability forms from the chart, attach the supporting records, and place each form in the provider's queue to review and sign. Diagnosis codes are read from the provider's documentation, never added. ### Can AI fill out FMLA and disability forms? Yes. FMLA and disability forms are one of the workflows Clicks runs today. The agent reads the chart, fills each field, and places the form in the provider's queue to review and sign. ### Does the agent add diagnosis codes? No. Diagnosis codes are read from the provider's documentation, never added by the agent. Anything unclear or conflicting goes to your team. ### Which forms can Clicks fill? Any form your team fills from the chart today, including state-specific pre-certification forms like the New Jersey APTP, payer forms, and FMLA and disability paperwork. ## Verify every workers' comp claim before the visit Source: https://clickshealth.com/repetitive-work/workers-comp-claim-verification Before a workers' comp patient is scheduled, someone has to confirm the claim, find the current adjuster, and check which body parts are authorized. Clicks agents do it in the carrier portal for every referral. A workers' comp referral comes in. Someone logs into the carrier or TPA portal, confirms the claim is open, finds out who the adjuster is this week, and checks which body parts and procedures are authorized. If the portal is unclear, they call. Skip a step and the visit happens against a claim that does not cover it. A shoulder gets treated on a claim that only covers the lumbar spine, and the bill is written off. ### Why the queue never shrinks - Every carrier has its own portal: Sedgwick, Gallagher Bassett, CorVel, and the rest each work differently. - Adjusters change: The contact on the referral is often not the person handling the claim today. - Authorization is body part specific: A visit outside the authorized body parts goes unpaid. ### Clicks handles - Verifies the claim in the carrier or TPA portal - Identifies the current adjuster and contact details - Confirms authorized body parts and procedures - Flags mismatches between the referral and the claim before scheduling - Writes the details into the EHR and updates adjusters and employers ### Your team keeps - Disputes with the carrier - Peer-to-peer reviews - Treatment plan decisions ### How can a practice verify workers' comp claims and authorized body parts automatically? Clicks Health agents log into the carrier or TPA portal that holds the claim, confirm it is active, identify the current adjuster, and check which body parts and procedures are authorized. Mismatches with the referral are flagged before the visit is scheduled. ### Which workers' comp carriers does Clicks work with? Any carrier or third-party administrator. The agent logs into whichever system holds the claim, Sedgwick, Gallagher Bassett, CorVel, The Hartford and Enlyte among them. If your team can reach a carrier's portal, so can the agent. ### Does this work for PIP and auto injury claims too? Yes. The same agents work personal injury protection claims, including the New Jersey APTP precertification form. ### Who is this workflow for? Orthopedic and spine practices with heavy workers' compensation and personal injury volume, and the pain management, physical therapy, and occupational medicine groups that run the same workflow. ## Comparisons ## AI agents vs RPA for healthcare revenue cycle automation Source: https://clickshealth.com/compare/ai-agents-vs-rpa RPA works when every case looks the same: the same screen, the same fields, the same clean data. Revenue cycle work rarely does. Payer portals change, documents arrive in every format, and the cases a bot cannot match land back in the queue. That is where the time goes. The 20% of cases legacy automation cannot handle become 80% of the work. AI agents read what is on screen, understand the document, and follow your SOP, so they work those cases instead of returning them. - How it works: RPA bots: Replays a recorded script step by step. Clicks agents: Reads the screen and decides the next step from your SOP. - Exceptions: RPA bots: Unmatched cases return to the queue. Clicks agents: Only cases that need judgment reach your team. - Documents: RPA bots: Needs clean data in fixed formats. Clicks agents: Reads charts, faxes, forms, and payer responses. - Screen changes: RPA bots: The script breaks until someone fixes it. Clicks agents: Reads the new screen the way a person would. - Phone and fax: RPA bots: Out of scope. Clicks agents: Calls payers and reads and sends faxes. ### Keep your bots, use agents for everything else If an RPA bot already runs a task reliably, keep it. But there is no reason to set up a new one. Clicks agents automate new workflows without scripts, take the exceptions your bots send back, and read the screen the way a person would when it changes. Keep your RPA bots for: - Tasks a bot already runs reliably - Screens and formats that never change - Bots that are cheap to maintain Use Clicks agents for: - Every new workflow you automate - The exceptions your bots send back - Work that means reading documents or calling payers ### What is the best alternative to RPA for healthcare revenue cycle work? AI agents that read the screen instead of replaying a script. Clicks Health agents follow your SOP across EHRs, payer portals, and documents, work the exceptions bots send back, and log every action. Teams often keep the bots that already work and move the rest to agents. ### Should we still start a new RPA project? No need. Clicks Health agents automate new workflows without scripts, including the stable ones, and they also take the exceptions a bot would send back. Keep the bots you already run, and use agents for everything new. ### What is the difference between RPA and AI agents? RPA replays a fixed sequence of clicks and keystrokes, so it needs stable screens and clean data. AI agents see the interface, read documents, and decide the next step from your SOP, so they handle the variation and exceptions that stop a bot. ### Is Clicks Health an RPA replacement? For anything new, yes. Keep the bots that already run reliably. Clicks agents take the exceptions those bots send back, and every workflow RPA was never a good fit for: payer portals that change, documents in every format, and calls to payers. ### How long does it take to move a workflow to Clicks? Clicks maps the manual steps, estimates the impact, and automates the selected workflow in 5 weeks or less, with the right controls in place. ## AI agents vs offshore RCM outsourcing Source: https://clickshealth.com/compare/ai-agents-vs-rcm-outsourcing Outsourcing and offshore teams solve a staffing problem by moving the work somewhere cheaper. The work itself stays manual: someone still logs into the portal, reads the remit, and types the note. Quality depends on training, turnover, and time zones. AI agents take the repetitive path itself. Work starts the moment it lands, every action is logged, and exceptions come back to your own team with the context attached. - Who does the work: Outsourcing: Another team, by hand. Clicks agents: AI agents, inside your systems. - Turnaround: Outsourcing: Tied to shifts and time zones. Clicks agents: Work starts the moment it lands. - Scaling: Outsourcing: More volume means more people. Clicks agents: Agents work as many cases at once as you send. - Knowledge: Outsourcing: Leaves with turnover. Clicks agents: Your SOP is followed the same way every time. - Visibility: Outsourcing: Reports after the fact. Clicks agents: Every agent action is logged and reviewable. ### Keep people on the work that needs people Many RCM operations run both. Agents take the repetitive queues, and people, in-house or outsourced, focus on the accounts that need judgment. Keep people for: - Patient conversations that need a human voice - Coding decisions that need certified coders - Accounts that need judgment or escalation Use Clicks agents for: - Repetitive queues like portal checks and posting - Work that has to start the moment it lands - Volume spikes, without adding people ### What are the alternatives to offshore medical billing outsourcing? Hiring in-house, or AI agents that do the repetitive work directly. Clicks Health agents work inside your own EHR, PM system, and payer portals, start the moment work lands, and route exceptions to your team, so the repetitive path stops being done by hand. ### Is AI cheaper than offshore RCM outsourcing? For repetitive, high-volume workflows it usually is, because the cost does not grow with headcount. In the orthopedics appeals case study, the cost per appeal fell to a quarter of the manual cost. Clicks estimates the impact for your workflow before automating it. ### Can we use Clicks alongside our outsourcing partner? Yes. Agents can take the repetitive queues while your partner keeps the work that needs people. Completed work and exceptions return to whichever queue or person you choose. ### Is patient data safe with AI agents? Clicks is SOC 2 Type II audited and HIPAA compliant. Agents use the same access you already grant your team, every action is logged, and data is encrypted at rest and in transit. ## AI agents vs hiring more revenue cycle staff Source: https://clickshealth.com/compare/ai-agents-vs-hiring-more-staff Hiring adds hands, but it also adds recruiting time, training, and turnover. And the new person spends most of the day on the same repetitive clicks as everyone else. AI agents take the repetitive path: the portal checks, the data entry, the drafted letters. Your team keeps the judgment calls, the payer escalations, and the patients. More volume no longer means more hiring pressure. - Time to capacity: Hiring: Recruit, onboard, and train. Clicks agents: One workflow automated in 5 weeks or less. - Volume spikes: Hiring: Backlog until the next hire. Clicks agents: Agents work as many cases at once as you send. - Turnover: Hiring: Knowledge leaves with people. Clicks agents: Your SOP is followed the same way every time. - What staff do all day: Hiring: Mostly repetitive clicking. Clicks agents: Exceptions, escalations, and patients. - Oversight: Hiring: Manual decisions are hard to audit. Clicks agents: Every agent action is logged and reviewable. ### Hire for judgment, automate the repetitive path Automating a workflow does not mean removing the human element. The repetitive path is automated, your team handles the exceptions, and your team remains accountable for the outcome. Hire people for: - Judgment, escalations, and patient conversations - Payer relationships - Workflows too rare to be worth automating Use Clicks agents for: - Portal checks, data entry, and drafted letters - Volume spikes, without a new hire - Work that has to follow your SOP every time ### How can a billing team handle more volume without hiring? Take the repetitive work off the team's plate. Clicks Health agents handle portal checks, data entry, drafted appeals, and payment posting inside the systems you already use, and work as many cases at once as you send. Your team keeps the judgment calls. ### Will AI agents replace our billing staff? No. Agents take the repetitive path so your staff can focus on the cases that need judgment, escalation, or a conversation. Exceptions route to your team and approvals stay where you put them. ### How much work can an agent take on? There is no queue. Work is processed the moment it arrives, and the agent works as many cases at once as you send it, so a spike in volume does not slow anything down. ### What does my team need to learn? Nothing new. No new tabs and no new logins. Work is assigned where it already lives, in the EHR, the worklist, or the queue your team runs, and it comes back done.