Eligibility & Benefits Verification Agent

Eligibility Pricing

Pay-as-you-go or predictable monthly plans — your choice

No minimums. No contracts. Pay only for checks you run.

Base Check

$0.50/transaction

EDI verification, Copays, Deductibles, data normalization

  • EDI eligibility verification
  • Copay & deductible extraction
  • Data normalization across payers
  • Coverage active/inactive status

Smart Resolve

$4.50/transaction

Data fix + retries + patient outreach

  • Everything in Base Check
  • Automatic data correction & retries
  • Patient outreach for missing info
  • Prior auth requirements flagged

Attempted

$1.00/transaction

Patient unreachable after max outreach

  • Retry across multiple channels
  • Max outreach attempts exhausted
  • Attempt log for audit trail

Calculate your savings

See how Agentman compares to manual verification costs.

500
1005,000
15%
5%30%
2
120

Agentman cost/mo

$1,190

Manual cost/mo

$6,720

CAQH benchmark: $6.72/check

You save/mo

$5,530

82% less than manual

Projected annual savings

$66,360

1,000 total checks/mo (500 x 2 providers)

Base Check (all)

1,000 x $0.50

Smart Resolve (15%)

150 x $4.50

Attempted (~10% of resolves)

15 x $1.00

How it works

1

Connect your PM/EHR

We integrate with AdvancedMD, athena, Epic, and 40+ systems.

2

Set your rules

Choose which appointments trigger checks and how far in advance.

3

Agent runs checks

Agentman queries payers via Agentic APIs — no portal logins needed.

4

Issues flagged

Inactive coverage, auth requirements, and benefit gaps are surfaced instantly.

5

Staff reviews exceptions

Your team handles the 5-15% that need human judgment. We handle the rest.

What's included with every check

All-payer coverage

Commercial, Medicare, Medicaid, and workers' comp — one agent handles them all.

HIPAA compliant

End-to-end encryption, BAA included, SOC 2 Type II in progress.

Real-time results

Most checks complete in under 10 seconds. Batch runs finish overnight.

Full audit trail

Every check is logged with timestamps, sources, and data lineage.

Analytics dashboard

Track check volume, pass/fail rates, payer response times, and savings.

Human escalation

Checks that can't be resolved automatically are routed to your staff with context.

Billing details

  • Consumption billing is metered daily and invoiced monthly.
  • Subscription plans are billed monthly. Cancel anytime — no long-term contracts.
  • Overage on subscription plans is billed at discounted rates (from $0.30–$0.40/check, $3.00–$4.00/resolve depending on plan).
  • Attempted transactions are only charged when Agentman initiates outreach — not when the patient is already unreachable.
  • EHR/PM integration is included with all subscription plans at no additional cost.
  • All prices in USD. Volume discounts available for 5,000+ transactions/month — contact us.

Stop paying $6.72 per eligibility check

Start with pay-as-you-go and see the savings in your first week. No setup fees, no contracts, no risk.