Family Care Center Cuts Insurance Verification Time by Two-Thirds Claim Status

Family Care Center was manually processing more than 3,600 insurance verifications each month, with each transaction taking up to 12 minutes. An Insurance Verification AI Agent reduced processing time to 4 minutes, achieved a 99.99% success rate, and contributed to an annual cost reduction of $124,291.

EHR

INFO REQ

Market

INFO REQ

Go-live

INFO REQ

The impact

Verification completed in one-third of the previous processing time

Two-thirds

Reduction in processing time per insurance verification.

$124,291

Annual cost reduction across 3,630 monthly verifications.

99.99%

Success rate achieved by the AI Agent.

12 to 4 minutes

Processing time reduced per verification

Client summary

Family Care Center is a mental health service provider in the United States with more than 40 locations. It offers therapy, psychiatric care, and treatments such as TMS to patients of all ages.

The organization was handling more than 3,600 insurance verification transactions each month. Manual verification took up to 12 minutes per transaction and placed pressure on its intake and eligibility team.

The opportunity

Manual verification was slowing patient onboarding across more than 40 locations

Verification Volume

The team processed more than 3,600 insurance verification transactions each month alongside thousands of patient appointments.

Intake Bottlenecks

Each manual verification took up to 12 minutes, creating delays in patient onboarding and making it difficult for the intake and eligibility team to keep pace with demand.

Accuracy and Capacity

As patient volume increased, so did the risk of verification errors, delayed care, and administrative strain. The organization needed a faster process that could support continued growth.

The approach

Droidal developed an Insurance Verification AI Agent to manage the workflow from patient-data extraction through eligibility checks, plan validation, issue flagging, and administrative reporting.

PHASE 1

Extract Patient and Payer Data

The AI Agent retrieves demographic and insurance information directly from Family Care Center’s EHR, removing the need for manual data entry.

PHASE 2

Verify Eligibility

It connects to payer portals and clearinghouses to check coverage status, plan details, and service eligibility.

PHASE 3

Flag Invalid Data and Coverage

The AI Agent identifies inactive policies, incorrect IDs, and other issues, then alerts staff before scheduling.

PHASE 4

Validate Benefits and Report

It identifies visit limits, co-pays, deductibles, and authorization requirements, then emails a detailed post-verification summary to the administrative team.

Agents deployed

Our Insurance Verification AI Agent supports the workflow from EHR data extraction through review

Patient and Payer Data Extraction

86%

Retrieves demographic and insurance information from the EHR without manual data entry.

Real-Time Eligibility Verification

79%

Connects to payer portals and clearinghouses to check coverage, plan details, and service eligibility.

Invalid Data and Coverage Flagging

64%

Identifies inactive policies, incorrect IDs, and other issues and alerts staff before scheduling.

Coverage Limit and Co-Pay Validation

92%

Captures plan-specific requirements, including visit limits, co-pays, deductibles, and authorization requirements.

Post-Verification Reporting

78%

Generates a detailed summary after verification and emails it to the administrative team for review.

By the end of 2026, Lima Memorial 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 team hand over in five weeks?

We’ll map your intake and follow-up workflows against the ones Droidal agents already run and show you the hours on the table.