agents × healthcare

Enterprise AI agents for healthcare.

Agents that draft prior auths, adjudicate claims, and distill clinical records into the facts that matter — running on on-prem inference that keeps PHI inside your walls and routing every clinical call to a licensed human. HIPAA-grade by construction.

On-prem PHI inference Prior auth + claims Clinical sign-off gates

Take administrative weight off clinical staff

Healthcare's labor crisis is as much administrative as clinical. Nurses spend hours assembling prior-authorization packets, billing teams rework denied claims, and physicians scroll through hundreds of pages of records to find the three data points that change a decision. The work is high-volume, deadline-bound, and governed by criteria that rarely change — and every minute spent on it is a minute not spent on a patient. That is the load an agent is built to carry.

An eeko healthcare agent pulls the relevant chart sections, matches them against payer medical-necessity criteria, and produces a complete, cited packet or summary — then hands anything that requires clinical judgment to a licensed reviewer. Crucially, it does this without PHI ever leaving your environment: inference runs on-prem or in your HIPAA-eligible cloud, access is minimum-necessary, and every read and action lands in an audit log your privacy officer can inspect.

Agents that respect the chart and the rules.

Three hardened layers, built around PHI handling and clinical accountability.

01 / toolingCORE
Tool-calling into healthcare systems
Typed, permissioned connectors into your EHR, payer portals, clearinghouses, and scheduling — over HL7/FHIR and X12 — so the agent reads and acts through controlled interfaces, never with broad credentials.
  • FHIR / HL7 EHR integration
  • X12 claims & eligibility
  • Payer-portal prior-auth submission
02 / retrievalCORE
RAG on healthcare data
Grounded retrieval over the patient chart, clinical notes, payer medical-necessity criteria, and coding guidelines so every summary and determination cites the source line in the record.
  • Chart & clinical-note retrieval
  • Medical-necessity criteria + ICD/CPT
  • Patient-scoped, minimum-necessary access
03 / oversightSECURE
Audit, guardrails & human-in-the-loop
PHI stays in your environment, every access is logged immutably, and a licensed clinician signs off on anything that touches a care or coverage decision.
  • On-prem / HIPAA-cloud inference
  • Append-only PHI access logs
  • Clinician sign-off on care decisions

Where AI agents pay back in healthcare

Returns land first in the administrative chokepoints that delay care and bleed margin:

  • Prior authorization — agents match the order to payer criteria, assemble the supporting documentation from the chart, and submit a complete packet, cutting turnaround from days to minutes and reducing avoidable denials.
  • Claims & denials management — automated coding review, clean-claim checks, and denial triage that drafts the appeal with the supporting clinical evidence already attached.
  • Clinical document summarization — agents compress hundreds of pages of records into a cited, reviewer-ready synopsis for utilization review, referrals, or care transitions.
  • Provider & patient operations — eligibility verification, referral coordination, and inbound-message triage that frees front-office and care-management staff for the cases that need a human.

Common questions.

How do AI agents apply to healthcare?

AI agents take on the administrative load that pulls clinicians and staff away from patients — assembling and submitting prior-authorization packets, adjudicating and appealing claims, and summarizing sprawling clinical records into the few facts a reviewer actually needs. Each agent reads from the EHR and payer portals through controlled interfaces, grounds every output in the chart and the medical-necessity criteria, and routes anything clinical to a licensed human before it counts.

How do you protect PHI and stay HIPAA-compliant?

Agents run on inference that stays inside your environment — on-prem or in your own HIPAA-eligible cloud — so PHI never leaves your control and no patient data is sent to a third-party model. Access is minimum-necessary and role-scoped, every read and action is written to an append-only audit log, and we operate under a BAA with clinical sign-off gates in front of any decision that affects care.

Related paths.

Give your clinicians their hours back.

Point us at your heaviest administrative workflow — prior auth, denials, or record review — and we will scope an agent that runs on PHI-safe infrastructure with a clinician in the loop. Response inside 24 hours.

Markets served.

As an enterprise AI agency, eeko systems delivers production AI systems remote-first across the United States and internationally — including these markets:

New York City, New York (NY)

Los Angeles, California (CA)

Chicago, Illinois (IL)

Houston, Texas (TX)

Phoenix, Arizona (AZ)

Philadelphia, Pennsylvania (PA)

San Antonio, Texas (TX)

San Diego, California (CA)

Dallas, Texas (TX)

San Jose, California (CA)

Austin, Texas (TX)

Jacksonville, Florida (FL)

Fort Worth, Texas (TX)

Columbus, Ohio (OH)

Charlotte, North Carolina (NC)

Indianapolis, Indiana (IN)

San Francisco, California (CA)

Seattle, Washington (WA)

Denver, Colorado (CO)

Washington, District of Columbia (DC)

Boston, Massachusetts (MA)

El Paso, Texas (TX)

Nashville, Tennessee (TN)

Detroit, Michigan (MI)

Oklahoma City, Oklahoma (OK)

Portland, Oregon (OR)

Las Vegas, Nevada (NV)

Memphis, Tennessee (TN)

Louisville, Kentucky (KY)

Baltimore, Maryland (MD)

Milwaukee, Wisconsin (WI)

Albuquerque, New Mexico (NM)

Tucson, Arizona (AZ)

Fresno, California (CA)

Sacramento, California (CA)

Kansas City, Missouri (MO)

Atlanta, Georgia (GA)

Miami, Florida (FL)

Colorado Springs, Colorado (CO)

Raleigh, North Carolina (NC)

Omaha, Nebraska (NE)

Long Beach, California (CA)

Virginia Beach, Virginia (VA)

Oakland, California (CA)

Minneapolis, Minnesota (MN)

Tulsa, Oklahoma (OK)

Arlington, Texas (TX)

New Orleans, Louisiana (LA)

Wichita, Kansas (KS)

Cleveland, Ohio (OH)

Tampa, Florida (FL)

Bakersfield, California (CA)

Aurora, Colorado (CO)

Honolulu, Hawaii (HI)

Anaheim, California (CA)

Santa Ana, California (CA)

Corpus Christi, Texas (TX)

Riverside, California (CA)

Lexington, Kentucky (KY)

St. Louis, Missouri (MO)

Stockton, California (CA)

Pittsburgh, Pennsylvania (PA)

Saint Paul, Minnesota (MN)

Cincinnati, Ohio (OH)

Greensboro, North Carolina (NC)

Anchorage, Alaska (AK)

Plano, Texas (TX)

Lincoln, Nebraska (NE)

Orlando, Florida (FL)

Irvine, California (CA)

Newark, New Jersey (NJ)

Toledo, Ohio (OH)

Durham, North Carolina (NC)

Chula Vista, California (CA)

Fort Wayne, Indiana (IN)

Jersey City, New Jersey (NJ)

St. Petersburg, Florida (FL)

Laredo, Texas (TX)

Madison, Wisconsin (WI)

Chandler, Arizona (AZ)

Buffalo, New York (NY)

Lubbock, Texas (TX)

Scottsdale, Arizona (AZ)

Reno, Nevada (NV)

Glendale, Arizona (AZ)

Gilbert, Arizona (AZ)

Winston-Salem, North Carolina (NC)

North Las Vegas, Nevada (NV)

Norfolk, Virginia (VA)

Chesapeake, Virginia (VA)

Fremont, California (CA)

Garland, Texas (TX)

Richmond, Virginia (VA)

Baton Rouge, Louisiana (LA)

Boise, Idaho (ID)

San Bernardino, California (CA)

Spokane, Washington (WA)

Des Moines, Iowa (IA)

Modesto, California (CA)

Birmingham, Alabama (AL)

Tacoma, Washington (WA)

Fontana, California (CA)

Oxnard, California (CA)

Fayetteville, North Carolina (NC)

Huntsville, Alabama (AL)

Moreno Valley, California (CA)

Rochester, New York (NY)

Glendale, California (CA)

Yonkers, New York (NY)

Augusta, Georgia (GA)

Amarillo, Texas (TX)

Little Rock, Arkansas (AR)

Akron, Ohio (OH)

Shreveport, Louisiana (LA)

Grand Rapids, Michigan (MI)

Mobile, Alabama (AL)

Salt Lake City, Utah (UT)

Huntsville, Texas (TX)

Tallahassee, Florida (FL)

Overland Park, Kansas (KS)

Knoxville, Tennessee (TN)

Worcester, Massachusetts (MA)

Brownsville, Texas (TX)

New Port Richey, Florida (FL)

Jackson, Mississippi (MS)

Providence, Rhode Island (RI)

Fort Lauderdale, Florida (FL)

Sioux Falls, South Dakota (SD)

Tempe, Arizona (AZ)

Cape Coral, Florida (FL)

Springfield, Missouri (MO)

Pembroke Pines, Florida (FL)

Eugene, Oregon (OR)

Peoria, Arizona (AZ)

Corona, California (CA)

Lancaster, California (CA)

Rockford, Illinois (IL)

Salinas, California (CA)

Palmdale, California (CA)

Springfield, Massachusetts (MA)

Charleston, South Carolina (SC)

Duluth, Minnesota (MN)

London, England (ENG)

Dublin, Ireland (IRE)