Claim Status and Follow Up Agent
Know what happened to every open claim
Rinova checks clearinghouse and payer status through available APIs and approved portal workflows, writes updates to the accounts receivable queue, and identifies the claims that need follow-up.
From open account to the right next action
Synthetic records only. No patient information.
Human review branch: see “Denied” and “No record found”, where the agent stops and a person takes over.
The payer has the claim and is still adjudicating it.
Current step
CompletedSetting next check
The account is updated and the next check is calculated using the customer's rules.
- Next action
- Recheck in 7 days
The agent uses available APIs first and agentic portal workflows when an API cannot supply the required status.
Step 4 of 4. Setting next check. Completed.
What to expect
Scheduled status checks without manual portal queues
APIs first where available, portal workflows where needed
Clear next action, owner, and follow-up date
Up to 5x
Faster reimbursement across Rinova workflows
Results vary by organization, specialty, payer mix, claim volume, system access, workflow scope, and starting performance.
What the agent can handle
- Selects open claims using configured age, payer, amount, and status rules
- Checks clearinghouse and payer APIs where available
- Uses approved payer-portal workflows when required
- Captures current status, relevant dates, payer messages, and reference numbers
- Updates the designated EHR, practice management, or accounts receivable queue
- Applies the organization's next-action and follow-up timing rules
- Routes missing, stalled, denied, or ambiguous claims to staff
- Preserves a history of checks, responses, and changes
Payer support
Check claim status support
Search for the payers your organization works with and add them to the table to see whether Rinova currently supports claim status checks for each one.
Search by payer name, alternate name, or payer ID. Use the arrow keys to move through results and Enter to add one.
No payers added yet
Search above and add the payers your organization works with. They will appear here with their current support status.
Payer availability can change. Contact Rinova to confirm current support and workflow requirements.
Data current as of October 6, 2026.
Follow-up rules remain customer controlled
The organization defines which claims the agent can check, how often it can act, where results are written, and which outcomes require staff review. The agent does not make voice calls, contact patients, or perform collection activity.
Claim Status and Follow Up questions
It can use both. The workflow uses APIs when they provide the required status and agentic portal activity when approved and necessary.
Yes, when the required system access and destination are configured. The agent can write the status, source, timestamp, next action, and follow-up date to an approved location.
The agent records the sources checked and routes the claim according to the organization's rules, which may include submission research, resubmission review, or staff escalation.
Related AI Agents
- Rejection and Denial Management AgentReads payer responses, classifies root causes, completes approved corrections, and prepares review-ready appeal work.View agent
- Payment Posting and Reconciliation AgentReads approved ERA and EOB data, posts payments and adjustments, reconciles against approved records, and flags variance.View agent
Replace repetitive status checks with a focused worklist
We will review your accounts receivable rules and show how the agent turns payer responses into clear next actions.