You didn’t take this role to chase denied claims at midnight.
Kognitos automates healthcare revenue cycle operations, claims denial management, prior authorization, and patient billing, with HIPAA-compliant, deterministic neurosymbolic AI. Revenue cycle teams go live in hours, not months, with zero hallucinations and a full audit trail, end-to-end.
Recognized by Leading Analysts
Your revenue cycle is bleeding margin. Here’s what it’s costing you.
Preventable denials. Up to 90% of denials are preventable, but most tools catch issues after the fact, not before submission.
3–5 days 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 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.
Production-grade 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.
End-to-end provider billing automation.
Match claim to encounter by patient ID and DOS. If paid amount < contracted amount, flag as underpayment. Route to collections if unpaid after 30 days.
60% reduction in billing cycle time.
3x faster claim resolution, with payment posting and reconciliation built in.
Your workflows are different. Describe them in plain English.
Four more healthcare apps, each designed in hours on the Kognitos platform, with governance, audit, and scale built in.
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.
For each claim in batch:
Validate medical necessity against payer policy.
If documentation missing, request from provider.
Flag fraud indicators exceeding threshold.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.
Check patient against HRSA 6-factor test.
If encounter qualifies AND provider is registered,
approve for 340B pricing.
Log decision with full audit trail.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.
Extract referral details from incoming fax.
Verify insurance and authorization status.
Match to specialist by specialty, location, and availability.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.
Retrieve patient call records from SharePoint.
Analyze for medication changes and ER visits.
Generate timeline report and send summary to Teams.Revenue cycle teams already fixed this. Live in hours, not months.
Named a Sample Vendor in the Gartner® Hype Cycle™ for AI in Finance, 2025. Trusted across regulated industries including healthcare.
Why one platform beats four point solutions.
4 vendors, 4 contracts, 4 data silos, 4 integration headaches. Or a single engine with shared data, governed end-to-end and HIPAA by design.
| Point solutions | Kognitos | |
|---|---|---|
| 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 |
In production. At scale. Measurable ROI.
97% reduction in audit time.
Manual compliance evidence collection consumed thousands of hours each quarter across regulated operations. Evidence collection is now fully automated, from thousands of hours to continuous monitoring.
92K hrs saved annually.
Finance automation was blocked by manual processes across 200+ countries in a highly regulated environment. Platform-wide automation now runs across AP, AR, reconciliation, and close, the same engine that powers healthcare workflows.
5x faster exception resolution.
Edge cases were escalated manually, slowing resolution across claims and compliance workflows. Now every edge case is encoded into deterministic logic, governed, auditable, and HIPAA-compliant.
Governed end-to-end. HIPAA by design.
One platform for every healthcare workflow. Single engine. Shared data. Governed end-to-end.
SOC 2 Type II certified.
Independently audited security controls across availability, confidentiality, and processing integrity.
HIPAA compliant.
Full PHI handling with audit trails, access controls, and data processing agreements.
GDPR ready.
Data residency controls, right-to-erasure support, and full processing transparency.
RBAC & governance built in.
Role-based access controls on who can run, modify, approve, and audit automations.
Connects to the systems your org already uses.
130+ pre-built integrations across EHR and practice management, clearinghouses and payers, ERP and financials, cloud and data, and collaboration and workflow tools.
FAQs
Prior auth is killing our clinical staff’s time, how quickly can Kognitos automate the submission and follow-up process with payers, and does it handle payer-specific portal differences?
Kognitos significantly accelerates prior authorization cycles. Using advanced computer vision, digital agents navigate shifting payer portals, extract patient documentation from EHRs, submit auth forms, and check status autonomously, reducing clerical burdens on clinical teams.
Our RCM team is juggling Epic, Cerner, and a payer portal that changes its UI every quarter, how does Kognitos stay connected to all of them without constant maintenance?
Unlike legacy bots that break during UI updates, Kognitos uses a resilient neurosymbolic AI model. When a payer changes an online layout, our platform adapts to the change or uses conversational exception handling to confirm the shift with an admin, preventing script failures.
We operate across 8 hospitals and 40 clinics, can we deploy once and scale across all entities, or is each site a separate implementation?
You can deploy your digital workflows centrally and scale them across all sites. Kognitos handles site-specific variances through natural language rules, allowing a master clinical automation template to adapt dynamically to distinct regional clinics without separate builds.
What’s a realistic first use case to deploy in under 30 days that shows measurable impact to leadership?
Automating incoming medical record indexing or patient intake document validation is an ideal 30-day use case. It yields high accuracy improvements and immediate time savings, establishing a clear proof of concept for hospital leadership.
How can AI automate claims denial management?
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.
What is agentic AI in healthcare?
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.
How does Kognitos ensure HIPAA compliance?
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.
How does Kognitos eliminate hallucinations in healthcare automation?
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.
How does Kognitos handle exceptions in healthcare workflows?
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.
Can revenue cycle teams build automations without coding?
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.
Stop overpaying for software. Start transforming.
Revenue cycle teams go live in hours, not months, with zero hallucinations and a full audit trail, end-to-end.