Selected work
Case study

RCM and clinical workflow automation on a brownfield stack

Widal embedded with a healthtech operator running on AdvancedMD to ship claims, eligibility, and prior authorization automation. We did the work as a brownfield overlay, no replatform, no rip and replace. Millions of claims processed since launch.

Outcome

The number that moved

Millions

Claims processed through the pipeline.

The challenge

Automate the revenue cycle without replatforming.

  • 01

    Replace manual eligibility checks and prior auth submissions with reliable automation, on top of a multi-year AdvancedMD footprint.

  • 02

    Connect claims, eligibility, and prior auth pipelines to clinical workflow events, so denials route back to the team that can act on them.

  • 03

    Get to production fast without disrupting the day-to-day RCM team.

  • 04

    Maintain HIPAA alignment across vendor and payer integrations.

The solution

An agent overlay on AdvancedMD.

  • 01

    Built an agent-friendly integration layer over AdvancedMD using its existing APIs, so the platform itself never had to change.

  • 02

    Automated eligibility verification with payer integrations, with structured error handling for the messy real-world cases.

  • 03

    Shipped prior auth submission automation with policy-aware document generation and human review gates for non-standard payers.

  • 04

    Integrated denial management with clinical workflow alerts so the right team sees the right exception with the right context.

  • 05

    Wired observability across the entire pipeline: claim journey traces, payer response monitoring, denial reason classification.

Stack
Node.jsPostgresTemporalAdvancedMD APIX12 EDIAnthropic ClaudeKafka
The impact

Brownfield automation at scale.

  • 01

    Processed millions of claims through the automated pipeline since launch.

  • 02

    Reduced manual eligibility and prior auth touch points across the RCM team.

  • 03

    Routed denials to the right owner faster, with the context needed to act.

  • 04

    Shipped the entire automation layer without a replatform, on a multi-year AdvancedMD footprint.

01

Millions

Claims processed through the pipeline

02

Brownfield

No platform migration required

03

X12 + API

Payer integration paths

04

HIPAA

BAA-aligned across the integration chain

Topics
RCMHealthtechWorkflow AutomationAdvancedMDClaimsPrior AuthorizationAgentic AI
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