Healthcare AI. Patient support and back-office that never sleeps.
An autonomous agent that runs the administrative and engagement layer of a healthcare operation — answering patients, booking visits, chasing claims and closing care gaps — while every clinical decision stays with your team. Proven in live operations through Tribe's healthcare company, CareHub.
DeployedWhat is a healthcare AI agent?
A healthcare AI agent is software that runs the administrative side of patient care on its own — answering patient calls and messages, booking and rescheduling visits, checking insurance eligibility, preparing prior authorizations and following up on claims — and hands anything clinical or sensitive to a person. Tribe's Healthcare AI does this 24/7 and is deployed in live operations at CareHub, Tribe's healthcare company.
Updated
| Status | Deployed — running in live operations today |
|---|---|
| Best for | Practices, clinics and health systems with heavy patient call volume, prior-auth queues or claim backlogs |
| Channels | Phone, chat, SMS and patient-portal messages |
| Hours | 24/7, 365 days |
| Languages | English and Spanish |
| Works with | Major EHR/PMS systems, payer portals, telephony and patient-messaging tools. |
| A person takes over when | Anything clinical, urgent or emotionally sensitive — passed to your team with the full context |
| Security | HIPAA-compliant and SOC 2 Type II, with full audit trails. |
| Platform | Runs on TIOS; built by CodingKey |
The work, done.
Real situations it handles.
After-hours patient calls
A patient calls at 9 p.m. to move an appointment. The agent confirms their identity, offers open slots from your schedule and sends a text confirmation. Urgent symptoms follow your on-call protocol instead.
Eligibility before the visit
Ahead of each appointment the agent checks coverage with the payer, flags inactive or changed plans, and prompts your front desk to collect updated details before the patient arrives.
Prior authorization packets
The agent gathers the documentation each payer requires, prepares the request and tracks it to a decision. A clinician reviews anything clinical before it goes out.
Denied-claim follow-up
Denials are sorted by reason. Correctable ones are fixed and resubmitted; appeals are prepared with the evidence for your billing team to decide on.
Care-gap outreach
Patients due for screenings or follow-ups get a reminder and a way to book — the kind of outreach that supports quality measures such as CMS Star ratings.
Refill and records requests
Requests are captured with the right details and routed to the provider or records team. The AI never approves a prescription.
A 9 p.m. reschedule, handled.
Answered
The agent picks up on the first ring, says it is a virtual assistant for your practice and asks how it can help.
Identity checked
It confirms who the patient is, using your verification rules, before discussing any appointment.
Slot booked
It offers open times from your scheduling system and books the one the patient picks.
Symptom mentioned
If the patient describes something urgent, it follows your protocol — 911 guidance or your on-call provider — and never gives medical advice.
Confirmed
The patient gets a text confirmation, and your front desk sees the change and the call summary in the morning.
Example for illustration — not a real customer conversation.
Plugs into your stack. Keeps humans in control.
Integrates with
Major EHR/PMS systems, payer portals, telephony and patient-messaging tools.
What stays human
All clinical judgment, medication approvals, distressed or complex patients, appeal strategy, and clinical-note sign-off.
Compliance. HIPAA-compliant and SOC 2 Type II, with full audit trails. See our security & compliance →
Why it matters now.
Prior authorization takes an average of 13 hours of physician and staff time every week, and 40% of physicians employ staff who work only on prior authorizations.
Insurers of plans sold on HealthCare.gov denied 19% of in-network claims in 2024.
Third-party figures, linked to their sources. They describe the industry, not Tribe's results.
What it takes, and what you can measure.
What you get: Round-the-clock patient access, faster reimbursement and fewer denials, more care gaps closed, and a lighter administrative load on clinical staff.
What we need from you
- Access to your EHR or practice-management system (a test environment first is fine)
- Visit types, provider calendars and booking rules
- Your after-hours and urgent-call protocol
- The payers and prior-authorization requirements you want covered
- A signed Business Associate Agreement (BAA)
What you can measure
- Calls and messages answered, by hour of day
- Appointments booked, rescheduled and cancelled
- Eligibility checks completed before the visit
- Prior authorizations prepared and their status
- Denied claims worked and resubmitted
- Conversations handed to staff, and why
Reported through TIOS. Tribe measures results on your own data rather than promising numbers up front.
The agent executes. Your people decide.
The agent handles the repeatable, high-volume work; your people own the decisions that matter. Human-in-the-loop escalation, full audit trails and security by default — built by CodingKey and proven in Tribe's own live operations before it reaches you. See our security & compliance.
Human. AI. Or both — your call.
Run it as an AI agent, keep it fully human, or blend the two — you choose the mix, and change it as your confidence grows.
People and AI together — your call. Agents handle the volume, your specialists own the moments that matter. Start where you like, and shift the mix as your confidence grows.
Not a demo — a running business.
This agent is informed by real operations inside Tribe's own companies:
Where this fits in our services.
The same work, run by specialists.
Not every operation should start autonomous. Most clients begin with a trained human team and move work to AI as confidence builds. If you want the human-delivered version of this vertical — scope, staffing and how the engagement runs — start there.
Often deployed alongside.
Healthcare AI, answered.
How is AI used in healthcare administration?
Is Tribe's Healthcare AI HIPAA compliant?
Does the AI make medical decisions?
Can it book appointments into our EHR or practice-management system?
Can AI help with prior authorizations?
Can AI reduce claim denials?
Where is Tribe's Healthcare AI proven?
Will Healthcare AI replace front-desk and billing staff?
How much does Healthcare AI cost?
How long does it take to deploy Healthcare AI?
Put this agent to work.
Tell us the workflow. We'll deploy an agent that runs it — with your people in control.