AI Agent AI-Powered Healthcare Claims Adjudication System Active

Compliance & Regulatory Agent

Verifies HIPAA-compliant data handling, validates ERISA fiduciary compliance for multi-employer plans, checks ACA preventive care mandates, confirms prior authorization requirements, and performs Coordination of Benefits (COB) analysis for members with multiple coverage..

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Parent Worker AI-Powered Healthcare Claims Adjudication System

Agent ID

compliance-checker

Portal Nexgile-AgentiCare Hub Taft-Hartley Benefits Administration Portal

Sector Multi-Employer Trust Fund Administration & Benefits Management

Status

Operational

Problem Statement

The challenge addressed

Healthcare claims must comply with HIPAA privacy rules, ERISA fiduciary requirements, ACA mandates, and plan-specific prior authorization rules while managing coordination of benefits.

Core Logic

How the agent solves it

System Navigation

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Portal

Nexgile-AgentiCare Hub Taft-Hartley Benefits Administration Portal

Digital Worker

AI-Powered Healthcare Claims Adjudication System

Current Agent

Compliance & Regulatory Agent

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