The Rise of AI Agents in Healthcare Operations
How autonomous agents are moving beyond simple chatbots to handle complex workflows in revenue cycle and patient access.
The first wave of AI in healthcare was about prediction: predicting readmissions, predicting denials, predicting disease progression.
The second wave is about action.
We are witnessing the rise of AI Agents—autonomous software tailored to specific domains that don’t just tell you what might happen, but actually do the work to fix it.
Beyond the Chatbot
Most “AI” in healthcare today is still passive. You ask a question, it gives an answer. An Agent, however, is given a goal.
- Goal: “Ensure this prior authorization is approved.”
- Agent Action: The agent logs into the payer portal, retrieves the clinical notes, identifies missing documentation, drafts the appeal letter, and submits it—keeping a human in the loop only for final review.
Revenue Cycle Autonomy
Revenue Cycle Management (RCM) is the perfect proving ground for Agents. The rules are complex but defined. The data is structured. The volume is overwhelming.
Our Revenue Operations Copilot doesn’t just flag denials. It understands why a claim was denied. It learns from past successful appeals. It drafts the necessary correspondence and updates the patient record. This shifts your RCM team from “data entry” to “strategy.”
Patient Access & Experience
On the frontstage, Agents are transforming patient access. Instead of a rigid IVR phone tree, an AI Voice Agent can handle appointment scheduling, medication refills, and triage.
But crucially, because it’s connected to our System of Intelligence, it has context. It knows the patient was just discharged yesterday. It knows their insurance changed. It creates a frictionless experience that feels personal, even at scale.
The Human-in-the-Loop
The goal isn’t to replace humans, but to elevate them. When Agents handle the repetitive, administrative burden, clinicians and staff can focus on what they do best: caring for patients.
The future of healthcare operations is hybrid. Human empathy + Agent efficiency. And at Health Foundry, we are building the platform to make that future a reality.