AI Agent Multi-Agent Insurance Claims Processing Digital Worker Active

Eligibility Verification Agent

Performs **real-time eligibility verification** against payer databases. Validates coverage status, effective dates, benefit limits, and plan-specific exclusions.

View Core Logic Back to Worker

Parent Worker Multi-Agent Insurance Claims Processing Digital Worker

Agent ID

eligibility-agent

Portal Nexgile-VitaAgent - Intelligent Healthcare Ecosystem

Sector Pharmaceutical Technology & Digital Health

Status

Operational

Problem Statement

The challenge addressed

**30% of claim denials** stem from eligibility errors—patients present with inactive coverage, exhausted benefits, or plan limitations unknown at point of service.

Core Logic

How the agent solves it

Performs **real-time eligibility verification** against payer databases. Validates coverage status, effective dates, benefit limits, and plan-specific exclusions. Uses GPT-4-Turbo for complex eligibil...

System Navigation

Explore related components

Portal

Nexgile-VitaAgent - Intelligent Healthcare Ecosystem

Digital Worker

Multi-Agent Insurance Claims Processing Digital Worker

Current Agent

Eligibility Verification Agent

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