Insurance Eligibility in Seconds
Insurance Eligibility in Seconds
Insurance Eligibility in Seconds
Meet the AI Agent replacing 5-day waits with 5-minute validations.
Meet the AI Agent replacing 5-day waits with 5-minute validations.
Manual insurance verification slows everything down—from surgeries to patient experience. With Odin AI’s Medical Insurance Validation Agent, hospitals can check eligibility, validate codes, and confirm coverage in real time—without lifting a finger.
Manual insurance verification slows everything down—from surgeries to patient experience. With Odin AI’s Medical Insurance Validation Agent, hospitals can check eligibility, validate codes, and confirm coverage in real time—without lifting a finger.
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The Hidden Roadblock to Patient Care
The Hidden Roadblock to Patient Care
It used to take 3–5 days to verify insurance eligibility for a single procedure. Behind every surgical delay is a stack of insurance paperwork.
It used to take 3–5 days to verify insurance eligibility for a single procedure. Behind every surgical delay is a stack of insurance paperwork.
Surgeons waiting on approvals
Staff juggling 50+ provider portals
Coverage rules changing every month
Staff juggling 50+ provider portals
Coverage rules changing every month
Delays in treatment
Burned-out admin teams
Patients stuck in uncertainty
Delays in treatment
Burned-out admin teams
Patients stuck in uncertainty
Surgeons waiting on approvals
It’s time to accelerate approvals, reduce errors, and improve care delivery.
It’s time to accelerate approvals, reduce errors, and improve care delivery.
With Odin AI, you go from “pending approval” to “ready to operate” in minutes.
With Odin AI, you go from “pending approval” to “ready to operate” in minutes.
Meet the Medical Insurance Validation Agent
Meet the Medical Insurance Validation Agent
Faster Approvals. Smarter Care Delivery.
Faster Approvals. Smarter Care Delivery.
Designed specifically for hospitals, surgical centers, and care providers, the Medical Insurance Validation Agent transforms how you verify coverage and eligibility.
Designed specifically for hospitals, surgical centers, and care providers, the Medical Insurance Validation Agent transforms how you verify coverage and eligibility.
It replicates the precision of top-tier billing staff—at machine speed and unlimited scale.
It replicates the precision of top-tier billing staff—at machine speed and unlimited scale.
Powered by advanced AI, it reads policy documents, validates CPT/ICD codes, syncs with provider portals, and flags non-compliant claims in real time.
Powered by advanced AI, it reads policy documents, validates CPT/ICD codes, syncs with provider portals, and flags non-compliant claims in real time.
How It Works
How It Works
Step 1: Code-Based Eligibility Checks
Step 1: Code-Based Eligibility Checks
CPT and ICD codes
Pre-authorization requirements
Plan-specific coverage criteria
Flags claims that don’t meet requirements-before they’re submitted.
Flags claims that don’t meet requirements-before they’re submitted.
Step 2: Policy Document Intelligence
Step 2: Policy Document Intelligence
Standardizes terminology across 50+ insurance providers
Detects exclusions, caveats, and hidden clauses
Maps everything into your hospital’s system
No more PDF digging or manual lookups-just real-time policy clarity.
No more PDF digging or manual lookups-just real-time policy clarity.
Step 3:Always Up-to-Date
Step 3:Always Up-to-Date
Ingests and interprets new policy updates in real time
Adjusts validation logic as payer rules evolve
Prevents delays caused by outdated policy assumptions
Your eligibility checks stay current-without any manual updates.
Your eligibility checks stay current-without any manual updates.
Step 4: Real-Time Portal Sync
Step 4: Real-Time Portal Sync
Authenticates securely across payer platforms
Pulls live eligibility and coverage data
Confirms insurance status instantly-at any scale
Authenticates securely across payer platforms
Pulls live eligibility and coverage data
Confirms insurance status instantly-at any scale
Saves hours per patient and eliminates data silos.
Saves hours per patient and eliminates data silos.
Step 1: Code-Based Eligibility Checks
CPT and ICD codes
Pre-authorization requirements
Plan-specific coverage criteria
Flags claims that don’t meet requirements-before they’re submitted.
Step 2: Policy Document Intelligence
Standardizes terminology across 50+ insurance providers
Detects exclusions, caveats, and hidden clauses
Maps everything into your hospital’s system
No more PDF digging or manual lookups-just real-time policy clarity.
Step 3:Always Up-to-Date
Ingests and interprets new policy updates in real time
Adjusts validation logic as payer rules evolve
Prevents delays caused by outdated policy assumptions
Your eligibility checks stay current-without any manual updates.
Step 4: Real-Time Portal Sync
Authenticates securely across payer platforms
Pulls live eligibility and coverage data
Confirms insurance status instantly-at any scale
Saves hours per patient and eliminates data silos.
From Guesswork to Precision - In Real Numbers
From Guesswork to Precision - In Real Numbers
Metric
Metric
Time to validate insurance
Time to validate insurance
Manual effort per procedure
Manual effort per procedure
Admin team workload
Admin team workload
Eligibility accuracy
Eligibility accuracy
Delays in scheduling
Delays in scheduling
Coverage clarity
Coverage clarity
Scalability
Scalability
-
-
Before (Manual)
Before (Manual)
3–5 days
3–5 days
~45–60 minutes
~45–60 minutes
100+ hours/week
100+ hours/week
~65–75% (manual error risk)
~65–75% (manual error risk)
Common & costly
Common & costly
Common & costly
Common & costly
Unclear, varied by portal
Unclear, varied by portal
Staff-limited
Staff-limited
Staff-limited
Staff-limited
-
-
After (With AI Agent)
After (With AI Agent)
< 5 minutes
< 5 minutes
< 10 minutes
< 10 minutes
↓ 70%
↓ 70%
2.5× higher
2.5× higher
Significantly reduced
Significantly reduced
Real-time, standardized
Real-time, standardized
Fully automated, infinite scale
Fully automated, infinite scale
-
-
Proof in Performance: What the Data Shows
Proof in Performance: What the Data Shows
95%+ reduction
95%+ reduction
in insurance verification time
in insurance verification time
2.5× improvement
2.5× improvement
in validation accuracy
in validation accuracy
70% less admin burden
70% less admin burden
for eligibility checks
for eligibility checks
More on-time surgeries and admissions
More on-time surgeries and admissions
Always compliant with latest payer policies
Always compliant with latest payer policies
95%+ reduction
in insurance verification time
2.5× improvement
in validation accuracy
70% less admin burden
for eligibility checks
More on-time surgeries and admissions
Always compliant with latest payer policies
Why It Matters
Why It Matters
Insurance eligibility is the first step in patient care. If that step fails-everything stalls. The Validation Agent ensures:
Insurance eligibility is the first step in patient care. If that step fails-everything stalls. The Validation Agent ensures:
Faster scheduling and better patient experience
Faster scheduling and better patient experience
Consistent coverage interpretation across insurers
Consistent coverage interpretation across insurers
Reduced denials due to policy mismatches
Reduced denials due to policy mismatches
Real-time clarity, without administrative delays
Real-time clarity, without administrative delays
Improved team morale, lower burnout, and scalable ops
Improved team morale, lower burnout, and scalable ops
Care Can’t Wait. Now It Doesn’t Have To.
Care Can’t Wait. Now It Doesn’t Have To.
With the Medical Insurance Validation Agent, approvals happen in minutes, not days - fueling faster decisions, smoother workflows, and better outcomes.
With the Medical Insurance Validation Agent, approvals happen in minutes, not days - fueling faster decisions, smoother workflows, and better outcomes.
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© 2025 Copyright One Realm, Inc
© 2025 Copyright One Realm, Inc