Intake, records, and exceptions under policy.
Move packets, referrals, and administrative requests through one governed path: extract, check, approve, and record. Human gates stay on anything that touches coverage or clinical judgment.
Packet intake
Referrals and prior-auth files
Human gates
Coverage and exception decisions
Full trace
Every run on the record
BYODB
Records stay in your store
INBOUND PACKET
Prior authorization #PA-4418
Extracted payer, CPT codes, and clinical attachments from the inbound PDF pack.
Missing clinical note. Packet is incomplete against payer rule set.
Autonomous flow paused. A reviewer gets the gap list and the original file before anything is submitted.
HC-PA-4418Audit record: ImmutableConnects to the systems health operations already run
Interactive workflow preview
How health operations run with complete governance.
See how XYZGent moves a packet from intake to a recorded decision: extraction, payer rules, a human gate when the file is incomplete, and a write-back to the systems you already use.
Prior authorization packet review
Assembles the file against payer rules, surfaces gaps, and holds submission until a reviewer signs off.
Step-by-step workflow pipeline
Packet intake
Document intelligenceParsed 18-page PDF. Extracted member ID, payer, and three CPT codes.
Payer rule check
Policy engineMatched Aetna prior-auth checklist for CPT 70553. Two attachments required.
Completeness gate
Policy guardrailClinical note dated within 30 days is missing. Submission blocked.
Utilization review
Human approval gateQueued to UM nurse with gap list and original packet.
Portal and record sync
System updateWill submit to payer portal and write status back to the EHR-adjacent store.
Extracted packet fields
Verified payloadPolicy rule evaluation
Payer prior-auth completeness v4
Policy limit: Required attachments: order + recent clinical note
Evaluated value: Clinical note: missing
Timestamp: Today, 14:22:08 UTC
Environment: Private health operations cluster
Status: AWAITING_UM_SIGN_OFF
Operational scope
Delivering value across access, clinical admin, and revenue cycle.
The same operating layer for the teams that move packets, schedule patients, and resolve coverage questions. Clinical judgment stays with people.
Referral packet intake
Pull structured fields from faxes, portals, and PDFs, then route complete files to the right specialty queue.
Missing-information loops
Send a precise gap list back to the referring office instead of parking the referral in a manual pile.
SLA-aware assignment
Assign work against specialty, urgency, and capacity rules with a documented handoff.
Enterprise architecture
Designed for high scrutiny, built for private deployment.
Health operations need isolation, a recorded decision, and a human on coverage and clinical exceptions. XYZGent runs in your environment and writes to your store.
Private cloud and on-premises
Run the platform in your AWS, Azure, GCP, or on-premises environment. Tenant data stays inside your perimeter.
Customer-managed storage
Bring your own database. Workflow configs, documents, extraction payloads, and audit records route to your store.
Private model routing
Connect Azure OpenAI, Bedrock, or dedicated instances. Prompts and payloads are not used to train public models.
Governed endpoints
Publish an approved workflow as an internal API with keys, plans, and usage visibility for the teams that call it.
Packets
Assembled against payer rules before a person touches the file.
100%
Audit trace on every extraction, rule, and reviewer action.
Human
Gates on incomplete files, coverage exceptions, and clinical judgment.
Your DB
Records and attachments stay in the store you already operate.
Security and operational FAQs
Questions from operations, compliance, and engineering leaders.
Clear answers on private hosting, data storage, and governance controls.
Ready to put one health operations process into production?
Bring the packet or referral flow that is stalling. We will map the systems, controls, and agent design required to run it.