Nextech and Centene Integration for Patient Insurance Processing

Connect your systems. Your AI Deployment Engineer establishes secure integration between Nextech's specialty practice management platform and Centene's managed care systems, mapping how patient insurance data, eligibility information, and authorization workflows need to flow for government-sponsored programs. Define the workflow. You configure automated processes for insurance verification, prior authorization requests, and claims submission—specifying triggers, required data elements like patient identifiers and procedure codes, and compliance requirements specific to Medicaid and Medicare Advantage plans. AI Employees take over. Your AI Employees continuously monitor patient schedules in Nextech, automatically verifying eligibility with Centene's systems, submitting prior authorizations for specialty procedures, and processing claims according to managed care requirements without manual intervention. Monitor performance transparently. AI Judges audit every insurance transaction, validating accuracy of patient demographics (First Name, Last Name, DOB, Member ID), authorization status, and claims data while ensuring compliance with government healthcare program requirements and flagging issues immediately. Scale to more workflows. Once core insurance processing runs reliably, expand automation to include eligibility forecasting, denial management, payment reconciliation, and coordination of benefits across multiple managed care organizations serving your specialty practice.