Where a licensed clinician has to own the decision
Prior authorization submitted, claim flagged, or determination drafted.
Criteria matching, documentation checks, coverage rule evaluation.
Physician or licensed clinical reviewer, matched to specialty where required. Reviews within your SLA.
Structured determination with SHA-256 proof of who reviewed it, their license, and when.
Built by our team and community. Get inspired — or build your own.
AI drafts an adverse determination. A licensed clinician reviews and owns the decision before it goes out.
Volume and enterprise pricing available · you set the budget per task
What the human does: Licensed physician reviews the clinical record against coverage criteria, confirms or overturns the recommendation, and signs the determination with their name, license state, and specialty on the record.
Credential requirements vary by task. Some tasks are open to all verified operators.
AI handles routine authorizations. A clinician reviews the ones that fall outside criteria.
Volume and enterprise pricing available · you set the budget per task
What the human does: Licensed clinical reviewer evaluates requests that don’t cleanly match criteria and issues an approve, deny, or request-more-information decision within the regulatory clock.
Credential requirements vary by task. Some tasks are open to all verified operators.
AI recommends a code change. A licensed reviewer confirms before the claim is repriced.
Volume and enterprise pricing available · you set the budget per task
What the human does: Qualified clinical coder or physician reviews the documentation supporting the recommended code change and approves or rejects it.
Credential requirements vary by task. Some tasks are open to all verified operators.
AI drafts clinical content. A licensed clinician reviews and approves before it enters the record.
Volume and enterprise pricing available · you set the budget per task
What the human does: Licensed clinician reviews AI-generated clinical content for accuracy and completeness, and approves it into the patient record with attribution.
Credential requirements vary by task. Some tasks are open to all verified operators.
A growing number of states require a named, licensed clinician to own any AI-assisted adverse determination, with a tamper-resistant record identifying the reviewer, their license, and their specialty.
These are examples of what you can build. Create your own use case with the HumanAgent API or AgentEazy.
We can build a custom human checkpoint for any workflow.