Automate Every Healthcare RCM Workflow
With Deterministic, Agentic AI

Agentic AI in healthcare refers to autonomous software that can perceive, decide, act, and adapt within healthcare workflows — from claims processing to prior authorization to patient intake. Unlike traditional RPA, agentic AI handles exceptions, learns from human guidance, and executes multi-step processes. Kognitos ships pre-built healthcare workflows and lets teams build unlimited more in plain English — all executed deterministically with zero hallucinations via its neurosymbolic architecture.

Kognitos is HIPAA-compliant by design: full PHI handling with end-to-end encryption, granular role-based access controls, comprehensive audit trails logging every action, and signed Business Associate Agreements. The platform is also SOC 2 Type II certified with independently audited security controls across availability, confidentiality, and processing integrity.

Yes. Kognitos’s Prior Authorization Agent extracts clinical data from patient records, matches it against payer-specific authorization requirements, auto-submits requests when criteria are met, and tracks approval status with escalation workflows — achieving a 90% first-pass approval rate with full audit trails.

Healthcare cannot tolerate AI improvisation. Kognitos uses a patented neurosymbolic architecture that separates intent interpretation from execution. An LLM understands your business rules written in plain English, but a deterministic Symbolic Executor handles all execution. It cannot improvise, cannot hallucinate, and every variable is recorded — deterministic results by architecture, not by hope.

RCM point solutions address one function each — denial management, prior auth, billing, eligibility — with separate data models, integrations, and vendor contracts. Kognitos covers the entire healthcare operations lifecycle on a single engine with shared data, one integration layer, and consistent governance — lower TCO, no data silos, faster implementation, and a single audit trail across all workflows.

Kognitos offers 130+ pre-built integrations including Epic, Oracle Health (Cerner), Athenahealth, Availity, Waystar, Workday, SAP, Salesforce, ServiceNow, and more. The platform connects to EHRs, practice management systems, clearinghouses, payer portals, cloud platforms, and data warehouses.

When an automation encounters an exception — a claim with missing data, an auth request that doesn’t match payer rules, an eligibility check with conflicting results — Kognitos routes the issue with full context and a suggested resolution. Once a human resolves it, the platform permanently encodes that fix into its deterministic logic. Over time, 90%+ of exceptions auto-resolve — no retraining, no probabilistic drift.

Yes. English-as-Code means plain English instructions are the actual executable code. A revenue cycle director can write business rules and the platform compiles and executes them deterministically. Pre-built healthcare workflows ship ready to deploy, and teams can build unlimited more — no developers required.

Healthcare organizations using Kognitos report: 91% claims auto-resubmission rate, 90% first-pass prior auth approval rate, 70% reduction in intake processing time, 35% reduction in coding errors, and 100% audit-ready compliance documentation — with production-grade governance from day one.

Probabilistic AI generates statistically likely outputs — acceptable for drafting emails but dangerous for claims adjudication, clinical workflows, or HIPAA-regulated processes. Deterministic AI, as implemented in Kognitos’s neurosymbolic architecture, guarantees the same input always produces the same output. Every step is auditable, every decision is explainable, and there is zero risk of hallucinated data in patient records or financial transactions.

Healthcare organizations lose critical process knowledge when experienced staff leave. Kognitos captures institutional knowledge as English-as-Code — business rules written in plain English that become the executable logic. When the Resolution Agent encounters an exception and a human provides the fix, that knowledge is permanently encoded into the platform’s deterministic logic. It never degrades, never forgets, and is always auditable. Contact our team to see how it works for your workflows.