Agentic Claims Resolution

Unresolved insurance claims can quietly drain a behavioral health clinic’s revenue. Billers spend hours interpreting payer requirements, making repeated follow-up calls, correcting claims, and coordinating work across fragmented systems. The process is manual, reactive, and operationally exhausting.

As part of Hipp’s agentic billing platform, Agentic Claims Resolution reimagines claims follow-up as a seamless AI-assisted workflow. Instead of simply tracking claims, the system actively diagnoses issues, orchestrates next steps, and executes actions such as payer calls, claim corrections, and appeal preparation.

The platform centralizes claim monitoring in a unified interface that surfaces denied and at-risk claims, prioritizing what requires attention. When a claim is flagged, Hipp analyzes denial codes, claim data, and payer context to generate a structured resolution plan that users can review, edit, and approve with full transparency.

Execution is embedded directly into the workflow. Hipp can initiate payer calls, capture conversations through live transcription, convert outcomes into structured data, and prepare replacement claims and appeal letters for final review and submission. Human input remains focused on oversight and decision-making, while repetitive administrative work is handled by the system.

Over time, Hipp learns from historical outcomes to proactively surface revenue cycle trends and flag issues earlier in the workflow.

By reducing administrative burden, accelerating resolution timelines, and improving operational visibility, Hipp helps behavioral health teams recover revenue faster, so they can spend less time chasing claims and more time delivering quality patient care.