Your revenue cycle is bleeding margin.
Here’s what it’s costing you.

$5M+
lost to denied claims annually

Up to 90% of denials are preventable — most tools catch issues after the fact, not before submission.

3–5 days
wasted per prior authorization

Patients wait, procedures get delayed, and revenue sits in limbo while staff chase payer portals and fax machines.

4 vendors
for one revenue cycle

Denial management, prior auth, eligibility, billing — each from a different vendor with its own data model, contract, and integration headache.

Plus: your best biller retires and takes 20 years of payer-specific nuance with them. Every new mandate means a six-month IT project. And HIPAA compliance is bolted on, not built in.

See How to Fix This or try a live app free →

You didn’t take this role
to chase denied claims at midnight.

Revenue cycle teams already fixed this. They automated claims, prior auth, and billing on Kognitos — and went live in hours, not months. HIPAA-compliant, zero hallucinations, governed end-to-end.

from 3–5 days
4 hours
Prior auth turnaround
from $5M+ lost
91%
Claims auto-resubmission
from 70% manual
$2.1M+
Recovered annually per facility
not months
Hours
To deploy
See a 10-Minute Demo or try a live app free →
Gartner Named a Sample Vendor in the Gartner® Hype Cycle™ for AI in Finance, 2025. Trusted across regulated industries including healthcare.
Live Apps

Production-grade healthcare apps built in hours.
Try them now.

Each app was designed on the Kognitos platform. Scalable database, governed workflows, RBAC, audit trails, and exception handling — all production-ready and HIPAA-compliant.

Provider Claims Processor

Automates the provider billing workflow from charge capture through claim submission and payment posting. Tracks claim status, identifies underpayments, and accelerates revenue collection across payers.

English as Code
Match claim to encounter by patient ID and DOS.
If billed amount > allowed amount, flag as underpayment.
Route to collections if unpaid after 30 days.
  • ✓ End-to-end provider billing automation
  • ✓ Payment posting and reconciliation
60%
Reduction in billing cycle time
3x
Faster claim resolution

Payer Claims Analysis

Provides payer-side claims analytics and review. Analyzes claims patterns, validates medical necessity, identifies fraud indicators, and generates compliance reports for regulatory submissions.

English as Code
For each claim in batch:
  Validate medical necessity against payer policy.
  If documentation missing, request from provider.
  Flag fraud indicators exceeding threshold.
  • ✓ Claims pattern analysis across providers
  • ✓ Fraud and abuse indicator detection
40%
Faster claims adjudication
25%
Reduction in improper payments

340B Discount Eligibility Check

Automates HRSA 340B program eligibility verification using the 6-factor test. Validates patient encounters, provider status, and prescription data to ensure compliant 340B pricing — reducing audit risk and manual review time.

English as Code
Check patient against HRSA 6-factor test.
If encounter qualifies AND provider is registered,
  approve for 340B pricing.
Log decision with full audit trail.
  • ✓ Automated HRSA 6-factor eligibility check
  • ✓ Audit-ready documentation and run history
85%
Reduction in manual eligibility review
99%
Audit compliance accuracy

Patient Referral Processing

Automates the referral intake workflow — capturing referral details, validating insurance and authorization, matching patients to specialists, and routing with complete clinical context for faster scheduling.

English as Code
Extract referral details from incoming fax.
Verify insurance and authorization status.
Match to specialist by specialty, location, and availability.
  • ✓ Referral intake and data extraction
  • ✓ Specialist matching and scheduling
70%
Reduction in referral processing time
50%
Fewer referral-related delays

Patient Call Records Analysis

Retrieves patient call records from SharePoint, analyzes interactions including medications and ER visits, generates comprehensive reports with visual timelines, and sends formatted summaries to Teams.

English as Code
Retrieve patient call records from SharePoint.
Analyze for medication changes and ER visits.
Generate timeline report and send summary to Teams.
  • ✓ Automated call record retrieval from SharePoint
  • ✓ Visual timeline and report generation
80%
Reduction in manual record review
5min
From call data to Teams summary

These apps were each designed in hours on the Kognitos platform. Your workflows are different — describe them in plain English and Kognitos builds a production-grade app with governance, audit, and scale built in.

Build Yours
Platform vs. Point Solutions

Why one platform beats
four point solutions.

The Patchwork
◼◼◼◼

4 Point Solutions

4 vendors. 4 contracts. 4 data silos. 4 integration headaches.

Kognitos
★

One Platform. Every Healthcare Workflow.

Single engine. Shared data. Governed end-to-end. HIPAA by design.

Implementation
Months per tool
Hours
Maintenance
Per-tool dev teams
Zero-code, self-healing
Auditability
Varies by tool
Every step in plain English
Exceptions
Manual escalation
Auto-encoded by AI
Hallucination risk
Probabilistic AI
0% — by architecture
Who defines it
Developers / IT
RCM leaders + tech teams
Data silos
One per tool
Unified data layer
Total cost
4× vendor stack
Single platform

Covers Claims, Prior Auth, Billing, Eligibility, Patient Intake, and Compliance.

See a 10-Minute Demo Try It Free
Customer Results

In production. At scale.
Measurable ROI.

Fortune 200 Enterprise

Manual compliance evidence collection consumed thousands of hours each quarter across regulated operations.

97%
reduction in audit time

Evidence collection fully automated — from thousands of hours to continuous monitoring across compliance workflows.

Finance automation blocked by manual processes across 200+ countries in a highly regulated environment.

92K hrs
saved annually across finance automation

Platform-wide automation across AP, AR, reconciliation, and close — the same engine that powers healthcare workflows.

Edge cases escalated manually, slowing resolution across claims and compliance workflows.

5x
faster exception resolution

Every edge case encoded into deterministic logic, not escalated to a person. Governed, auditable, HIPAA-compliant.

TTX JBI Manufacturing Norco Industries Century Supply Chain Green Dot Builders FirstSource
Get Results Like These Try a Live App Free
130+ Integrations

Connects to the systems
your healthcare org already uses.

EHR & Practice Management
EpicEpic
Oracle HealthOracle Health
Athenahealth
MEDITECH
Clearinghouses & Payers
Availity
Waystar
Change Healthcare
Kognitos
ERP & Financials
SAPSAP
WorkdayWorkday
NetSuiteNetSuite
DynamicsDynamics
Cloud & Data
AWSAWS
AzureAzure
GCPGCP
SnowflakeSnowflake
DatabricksDatabricks
Collaboration & Workflow
SalesforceSalesforce
ServiceNowServiceNow
Microsoft 365Microsoft 365
SlackSlack
SharePointSharePoint
BoxBox
Google WorkspaceGoogle Workspace
VeevaVeeva
130+pre-built integrations View all →
See How It Connects to Your Stack

Stop overpaying for healthcare software.
Start transforming your operations.

Book Your Demo
SOC 2 Type II
Independently audited security controls across availability, confidentiality, and processing integrity.
Certified
HIPAA Compliant
Full PHI handling with audit trails, access controls, and data processing agreements.
Compliant
GDPR Ready
Data residency controls, right-to-erasure support, and full processing transparency.
Ready
RBAC & Governance
Role-based access controls on who can run, modify, approve, and audit automations.
Built in
FAQ

Frequently Asked
Questions

AI automates claims denial management by detecting denial patterns, categorizing root causes, assembling supporting documentation, and auto-resubmitting corrected claims within payer deadlines. Kognitos’s Claims Lifecycle Manager uses English-as-Code rules to monitor remittance files, identify actionable denials, match to payer-specific resubmission requirements, and route appeals with full context — recovering revenue that would otherwise be written off.

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.

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.

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.