Automate healthcare operations. Keep every rule in force.
Factify turns payer requirements, intake procedures, and approval rules into an executable rulebook that defines your agents' tools, with guaranteed adherence to every approved rule.
Why healthcare providers choose Factify
Healthcare rules, ready to run
Payer requirements, intake procedures, referral criteria, and approval limits become one executable rulebook. It defines the tools agents can use, with a named owner and approved version behind every rule.
100% rule adherence at execution
Agents execute through deterministic tools that enforce the approved rulebook. Routine administrative actions proceed within your rules. Undefined cases and required approvals go to the responsible team with the context to resolve them.
Update once. Keep teams aligned.
When payer requirements or internal procedures change, update and approve the rulebook once. Connected agent tools reflect the new version, keeping intake, authorizations, and billing aligned without maintaining each workflow separately.
Proof behind every action
Each action carries its inputs, source evidence, rulebook version, and approval history. When a payer questions a submission or an internal reviewer investigates a case, the action and its basis are already documented.
Where healthcare teams can put agents to work
Patient Intake & Registration
Validate registration details and required documents against approved intake rules. Flag gaps and route records to the right team before the next step.
Eligibility & Benefits Verification
Apply approved verification rules to payer responses. Flag missing or conflicting coverage details and route them for review with the supporting evidence.
Referral Processing & Scheduling
Route referrals using approved service, location, and scheduling criteria. Send incomplete requests or cases requiring clinical judgment to the responsible team.
Prior Authorization
Check requests against current payer requirements, assemble required documentation, and route missing information for review before submission.
Provider Credentialing
Check credentials, expiration dates, and required documents against approved criteria. Route incomplete records and required approval decisions to the credentialing team.
Claims Preparation & Billing
Check required fields, supporting records, and payer submission rules before a claim is sent. Route exceptions with the rule and evidence attached.
