Myndshft is a background infrastructure tool that automates the "investigative" phase of patient intake and ordering. When a clinician orders a service or specialty drug, the software instantly queries payers to determine (1) if the patient is covered, (2) if a prior authorization is required, and (3) whether that authorization falls under the patient’s medical benefit or pharmacy benefit. If an authorization is required, it autopopulates the necessary forms with clinical data from your system and submits them directly to the payer, bypassing the need for staff to log into individual insurance portals.

HealOS uses AI "agents" to autonomously log into payer portals and databases to verify patient insurance coverage and submit prior authorization requests. Instead of staff manually calling insurers or navigating multiple websites, the software retrieves detailed benefit information (deductibles, copays, network status) and determines authorization requirements in the background, presenting the results directly to the administrative team.

Phreesia’s Revenue Cycle module is an "AI-Enhanced" financial engine designed to secure patient payments before the visit happens. While traditional clearinghouses (like Availity) just tell you if insurance is active, Phreesia uses AI-Driven Copay Logic to predict the exact dollar amount a patient owes, even for complex procedure codes and prompts them to pay it digitally during check-in. It effectively turns your front desk into a "Self-Service Point of Sale."

Nirvana is a specialized AI engine built to solve the single most confusing part of private practice: "How much does this visit actually cost?" Unlike traditional clearinghouses that just spit back a raw "Active/Inactive" code, Nirvana uses AI to parse complex payer contracts and predict the exact patient responsibility (copay/deductible) in real-time. It is famous for its "Cardless Verification"—using machine learning to find a patient’s active insurance policy with just a name and DOB, even if the patient lost their card.