HealthAxis Cut Enrollment Processing Effort by 53% with an AI Agent

HealthAxis deployed an Enrollment AI Agent to process return-to-sender mail and create validated Call Center tickets. The workflow reduced monthly processing time from more than 51 hours to 24 hours while achieving a 99.47% success rate.

EHR

Market

Go-live

The impact

Less manual effort, faster processing, and greater accuracy

53%

Reduction in monthly processing effort

99.47%

Success rate achieved by the AI Agent

27.7Hrs

Labor time saved monthly across 615 enrollments

$17,220

Annual cost reduction

Client summary

HealthAxis provides healthcare management solutions for payers, providers, and third-party administrators. Its services include core administrative processing systems, business process as a service, business process outsourcing, staff augmentation, and consulting.

The enrollment team managed a daily volume of return mail that required documents to be opened, reviewed, validated, and converted into Call Center tickets.

The opportunity

Move Return-Mail Enrollment Work Out of a Repetitive, Screen-by-Screen Process

Document Review

Staff manually opened and scanned each document for the phrase “RETURN TO SENDER.”

Member Validation

Patient ID, member name, and date of birth had to be checked before the team could proceed.

Ticket Creation

Creating a Call Center ticket required multiple portal steps and accurate member data, increasing errors and delays.

The approach

Droidal developed an Enrollment AI Agent that moves each return-mail document through retrieval, validation, ticket creation, reporting, and post-processing.

PHASE 1

Retrieve Documents

The AI Agent accesses the shared drive, opens each client folder, and processes the PDF documents it finds.

PHASE 2

Detect and Validate

It scans each PDF for “RETURN TO SENDER,” then extracts and validates the patient ID, member name, and date of birth when the phrase is present.

PHASE 3

Create the Ticket

The Agent logs into the portal, searches for the member, verifies the information, selects the appropriate category and subcategory, enters standardized notes, and attaches the PDF when required.

PHASE 4

Report and Complete

After validating and saving the ticket, the Agent captures the ticket number for a summary report and moves the document to the “COMPLETED” folder.

Agents deployed

One Enrollment AI Agent manages the return-mail ticket workflow

DOCUMENT RETRIEVAL

86%

Accesses the shared drive, opens client folders, and processes the available PDF documents.

RETURN-MAIL DETECTION

79%

Scans each PDF for “RETURN TO SENDER” and extracts the required member information.

MEMBER VERIFICATION AND TICKET CREATION

64%

Searches for the member in the portal, verifies the extracted data, selects the correct ticket category, enters standardized notes, and attaches the source document when needed.

TICKET SUBMISSION AND REPORTING

92%

Saves the validated ticket, captures its number, and adds it to a summary report shared with the designated team.

POST-PROCESSING

92%

Moves completed return-mail documents into the “COMPLETED” folder for organized tracking.

By the end of 2026, HEALTHAXIS IS TARGETING

85%

of eligibility and benefits checks touchless

days in A/R across hospital and medical group

$4.2M

annualised net revenue recovered and retained

What Could Your Enrollment Team Hand Over to AI Agents?

Map the document review, validation, ticketing, and follow-up work that could move through an AI-supported enrollment workflow.