FAQ

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Ascertain is an AI-powered automation platform built for healthcare. Unlike static RPA tools or point solutions, our agentic AI adapts to complex, real-world workflows across the administrative and care cycle management, as well as internal payer processes like member enrollment and claims processing. We don’t just fill out forms automatically; we deliver full-service, end-to-end solutions that address your administrative costs and drive measurable ROI.

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Agentic AI refers to AI systems that can act autonomously after ingesting and interpreting structured and/or unstructured data; like clinical notes, payer portals, or faxes, even when user interfaces or document formats change. It goes beyond rigid automation by handling exceptions, and using audits to establish rules that scale seamlessly to new processes.

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Ascertain employs healthcare veterans with prior experience owning these workflows and managing teams of persons that did so. These Ascertain Assistants are brought in prior to sales, during implementations, and routine support for onboarded clients.

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Ascertain’s AI assistants automate manual, complex administrative workflows—such as eligibility checks, prior authorizations, and care and discharge planning; cutting clicks by up to 80% and submission time by 67% in pilots. This frees client teams to reclaim hours each week, reducing overtime, errors, and burnout. Health systems can handle more volume without proportional staff increases, driving labor savings and faster patient throughput.

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We establish baseline metrics (task time, click count, and error rate) before deployment, then track improvements in real time. For example, one client cut prior authorization clicks by 80% and submission time by 67%. We translate these gains into enterprise-level ROI—labor hours saved, faster revenue capture, greater patient throughput, and expanded capacity—delivered through transparent reports that make impact measurable from day one.

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Offshoring may cut costs, but it doesn’t solve the root problem—manual, error-prone work. Ascertain tackles this head-on with by automating the manual processes, while still keeping a human-in-the-loop. This eliminates variability, reduces risk, and delivers continuous, scalable savings without increasing headcount or depending on offshore teams.

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Yes. Born inside a major health system, Ascertain was designed to “snap” into existing workflows without rip-and-replace. We offer light integration for quick ROI validation and deeper integration for end-to-end automation. Our AI can log into EHRs, payer portals, and CRMs like a human user, enabling bi-directional data flow. This ensures interoperability even with legacy or closed systems.

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We can launch our solution in as little as 4–6 weeks. Our AI agents work with existing systems instead of requiring data lakes or major IT overhauls, organizations see value before deeper integrations are needed.

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By starting with a single workflow, organizations can then expand automation across the revenue cycle and care management, as well as internal payer processes like member enrollment and claims processing.

Ascertain automates manual, high-volume workflows including:

• Eligibility verification
  
• Prior authorization submission and follow-up
  
• UAS/ATSP audits and post-UAS care planning
  
• PCSP preparation and auditing
  
• Fax ingestion and document routing
  
• Payer portal submissions and status monitoring

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By focusing on administrative (not clinical) workflows, we minimize bias risk while maintaining compliance with HIPAA, HITECH, and payer requirements.

Our safeguards include:

• Full encryption, secure hosting, and BAAs
  
• Human review for all non-routine tasks
  
• Transparent, auditable logs of every AI and human action
  
• Continuous monitoring to detect errors or bias
  
• Internal teams of prior authorization and compliance specialists validating workflows

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