Claims processing is a core part of healthcare revenue cycle operations but often slows down due to manual work, inconsistent validation, and changing payer requirements. These gaps lead to denials, rework, and delayed payments.

Droidal Claims Processing AI Agent brings structure and consistency to the entire claims lifecycle. It pulls data from EHR systems, validates claims against payer rules, and prepares submission-ready claims with minimal manual effort. Required fields, codes, and documentation are checked before submission to help prevent rejections.

After submission, the system tracks claim status in real time and flags delays or errors. It supports correction, resubmission, and follow-up workflows, helping teams stay on top of claims and maintain steady reimbursement flow.

Droidal gives healthcare organizations a powerful advantage by offering more than 20+ AI agents that support the entire RCM process from start to finish. These agents handle insurance checks, claims, denials, Prior authorizations, and patient intake, helping teams reduce manual work and maintain smooth daily operations. With accurate data processing, cleaner claims, and faster follow-ups, organizations experience quicker reimbursements and stronger financial stability. Droidal works seamlessly with existing EHR systems, improves compliance, reduces denial risks, and ensures consistent performance even during staffing shortages. This allows healthcare organizations to achieve reliable revenue cycle results while focusing more on patient care.

There is a different way to work. If you were to reimagine the way you run your business, what would you do differently? What if you could save up to 80% of your operational costs by reimagining the way business outcomes are delivered?

Through the power of automation emerging technologies, we challenge you to think differently about how you work and how you use your people to full effective.

We can help you across the automation journey from thinking through your strategy to implementing and executing robotic process automation, machine learning and other emerging technologies across the enterprise.  

Revenue Cycle Management:

Prior Authorization ​

Insurance Claims - Posting

Patient Payment - Posting

Coordination of Benefits: Primary, Secondary, & Tertiary

Revenue Integrity - Payment Audits (Under & Over)

Provider: Insurance Enrollment

Revenue Integrity - Charge Description Master (CDM) Management

Revenue Integrity - IME or IMR Audits (CMS & Medicare Advantage)

Insurance Claims - Denied & Rejected Follow-Up

TQA Healthcare enables healthcare and life sciences organizations to transform the patient experience and reduce costs through increased personalization, intelligent automation, and AI. 

The practice’s solutions impact patient access, the revenue cycle, order processing, and clinical needs at the most critical stages of the patient journey, resulting in a seamless encounter.

By empowering individuals to actively manage their unique experiences, TQA Healthcare increases the satisfaction of every healthcare consumer: patients, staff, and clinicians.

Houston-based, TQA Healthcare is formerly Element Blue. 

Pre-submission claim validation: Checks claims for missing data, incorrect codes, and payer rule mismatches before submission to reduce rejections.

Payer-specific claim rules: Applies payer requirements to ensure each claim is accurate and submission-ready.

Denial handling workflows: Identifies claims likely to be rejected and supports correction and resubmission.

Real-time claim tracking: Monitors claim status across payers and highlights delays or pending actions.

Automated claim submission: Prepares and submits clean claims with minimal manual effort.

Accurate EHR updates: Writes claim status and updates back into EHR and billing systems for visibility.

Seamless Integration: Works with existing EHR, billing, and RCM systems without major changes.

HIPAA-Compliant and Secure: Ensures encrypted data handling with healthcare-grade security standards.

Faster Implementation: Ready-to-deploy workflows enable quick setup and faster impact.

Scalable Processing: Handles high claim volumes across multiple payers and specialties.

End-to-End Visibility: Provides real-time visibility into claim status, delays, and actions.

Continuous Optimization: Improves claim accuracy and processing workflows over time.

While EHRs offers integration tools, achieving seamless data exchange, particularly with non-EHR systems, can be challenging due to their limited interoperability.

This can create communication hurdles between providers using different EHRs, healthcare facilities not on a particular EHR, and providers who need to integrate with other advanced technology platforms outside of the EHR ecosystem.

TQA's solutions can integrate with any platform and are independent of particular products or technologies. This affords our teams unlimited creativity when ideating custom solutions for each healthcare organization.

TQA has a practice that is dedicated exclusively to healthcare and life sciences. This is unique among our UiPath competitors, who serve multiple industry verticals.

A UiPath Platinum partner, TQA is recognized as a leading systems integrator with more than 20 years' experience in working with some of the world's best known providers, payers, diagnostics, and life sciences organizations.