Healthcare
Built for the operations side of healthcare.
The AI operating partner for payers, providers and healthcare services companies: rules-based automation first, AI where it fits, people for judgment.
Who it is for
Choose your organization.
Administrative operations only. Each page shows that segment's queues, systems and boundaries.
- Often first: Pend queues, 834 fallout or prior auth intakeMeasured by: Pend age, turnaround, decision clocks met
- Often first: Benefit rechecks, auth status or the denial worklistMeasured by: Days in A/R, write-offs, staff hours per queue
- Often first: Denials, trip intake, chargebacks or carrier statementsMeasured by: Cost to serve, cash aging, turnaround
One representative workflow
One request, from fax to decision.
The same pattern runs through a plan's auth intake, a practice's referral queue and a services company's order desk.
- A request arrives by fax or portal and is read into intakeAI, person checks
- Eligibility and coverage checkedAutomation
- Case keyed into your system of recordAutomation
- Missing documents chasedAutomation
- The clinical, coding or plan decisionYour staff decide
- Notice sent and the case file kept for auditAutomation
Stays with your licensed staff: Clinical decisions, medical necessity, final codes and plan advice. We work the administrative queue around them.
Medicare distribution, anonymized
Healthcare servicesCommissions, HR and onboarding rebuilt while the business grew
A field marketing organization placing Medicare plans for 225,000+ lives through roughly 1,500 agents. Reliable Group rebuilt commissions, HR and onboarding around automation and AI, and gave agents a voice assistant for plan comparison and compliance. Sales capacity held and the business grew through the year, while the corporate team went from about 450 to under 200.
Grew, capacity held
One year: the business grew and sales capacity held. The corporate team went from about 450 to under 200.
anonymized realized
A Medicare insurance distributor, not a payer or provider. Our healthcare work spans 15 years; PHI-capable engagements are newer, and our first under a business associate agreement is in progress.
What transfers: Documents read, records reconciled and onboarding rebuilt with automation first and people on exceptions, the pattern behind most healthcare back offices.
How we handle regulated data
Design posture, not certification
- BAA
- Where a department handles protected health information, we execute a business associate agreement before Trace is installed or any data is accessed.
- HIPAA
- We execute a Business Associate Agreement before any engagement that touches PHI, and PHI is accessed only inside client-controlled systems by named individuals. Our first healthcare engagement under BAA is in progress.
- Posture
- Ready and aligned describe design posture, not certification. Reliable Group does not currently hold SOC 2 or ISO 27001 certification; our teams operate inside client-certified environments under client controls.
- Notice
- We deploy Trace only after your organization has given team members the written notice required in your state; we provide the notice template.
Last reviewed October 2026
Next step
Stop guessing how your operation works.
Start with a fixed-fee discovery: one department, six to eight weeks, a workflow map and a fixed-price proposal for the first build.