Wurklist Real-Time Eligibility Agent

Your Front Desk Has More Important Things to Do

Wurklist's Real-Time Eligibility Agent automates payer portal navigation, extracts real-time benefit data, and updates your EMR - all while keeping your staff in the driver's seat.
Most eligibility errors don't surface until a claim is denied. By then, the patient is gone and the money is lost. The Wurklist Eligibility Agent closes that gap by automating what front desk staff are expected to do manually - checking portals, comparing data, updating records - in under two minutes per patient.
See It in Action
Eligibility Agent
Wurklist Real-Time Verification
Online
Extracting plans from EMR... 09:12 AM
Extracted plans for this patient: 09:12 AM
Medicaid Access PA
MA-2281940
Primary
BlueCross Premier PPO
BCX-449812
Secondary
Checking eligibility for service date 02/25/2026 09:12 AM
Auto-login complete — PA Promise Portal 09:12 AM
Eligibility confirmed — Medicaid Active 09:12 AM
Auto-login complete — Waystar 09:12 AM
Eligibility confirmed — BlueCross Active 09:12 AM
COB reversal detected — Medicaid is Secondary 09:12 AM
Reviewing Coverage Details... 09:12 AM

💬Below is the COB order as per your EMR. Confirm or reorder.

Coverage Determination
⠿ BlueCross Premier PPO Primary
⠿ Medicaid Access PA Secondary
Requires your confirmation
Checking for updates in EHR... 09:13 AM

💬I found updates to post to your EMR. Review and click Update.

Patient Updates
First Name
SARA → SARAH M.
Plan Updates
BlueCross PPO · Effective Date
01/01/25 → 01/15/25
Medicaid PA · Effective Date
09/01/24 → 07/01/24
EMR updated successfully 09:13 AM
Verification Complete

Every action visible. Every step auditable.

The Problem

The Eligibility Process Is Broken - And You Only Find Out When It's Too Late

Portal Chaos

Front desk staff must log into dozens of payer portals, each with different interfaces, credentials, and data formats. There's no way to track if they're actually doing it.

Data Entry Errors

Even when staff check the portal correctly, manually re-entering coverage details into the EMR introduces errors that travel downstream to claims.

Knowledge Walks Out the Door

Front desk has the highest attrition in any practice. Every departure takes portal knowledge, login credentials, and workflow understanding with it.

You won't know about these failures until claims are denied. And by then, it's too late to recover.
HOW IT WORKS — STEP-BY-STEP FLOW

One Click. Full Verification. Zero Data Entry.

Step 1: Extract Plans from EMR

Extract Plans from EMR When a patient checks in, the Eligibility Agent automatically reads the insurance plans on file in Experity (or your EMR). No manual lookup required.

Plan Detection

Step 2: Navigate Payer Portals Automatically

Navigate Payer Portals Automatically The agent logs into the correct payer portal(s) — Medicaid, commercial carriers, state systems — handles authentication, and navigates to the eligibility verification page. Your staff never touches the portal.

Portal Navigation

Step 3: Compare & Verify Coverage

Compare & Verify Coverage The agent cross-references what’s in the EMR against what the payer portal reports. It identifies discrepancies, confirms active coverage, and extracts benefit details (copay, coinsurance, deductible, out-of-pocket max).

Data Comparison

Step 4: Human Confirmation

Human Confirmation When coordination of benefits or coverage order needs a decision, the agent presents the information clearly and asks for staff confirmation. The user stays in control — this is a copilot, not autopilot.

COB Confirmation

Step 5: Update EMR Automatically

Update EMR Automatically Once confirmed, the agent updates the EMR directly via RPA — correcting patient names, effective dates, plan details, and coverage order. No manual data entry. No errors.

EMR Update

Step 6: Benefits Summary

Benefits Summary A clean summary of verified benefits — copay, coinsurance, deductible remaining, out-of-pocket max – is immediately available for the visit. Stored permanently for future reference.

Benefits Summary
Why It Matters (Value Props)

Built for How Your Practice Actually Works

Mitigate Risk

Every skipped or botched eligibility check is money lost downstream. The Eligibility Agent creates an auditable record that every patient's coverage was verified before treatment - protecting your revenue at the source.

Reduce Turnover Pain

Front desk staff have the highest attrition in healthcare practices. The Eligibility Agent eliminates the need for portal-specific training, so new hires can be productive from day one. No more knowledge walking out the door.

Retain Your Best People

Nobody took a front desk job to fight with payer portals. By automating the most frustrating part of their workflow, the Eligibility Agent makes the job about what it should be - greeting patients and delivering great care experiences. Happier staff stay longer.

Origin Story / Credibility

We Built It for Ourselves First

The Eligibility Agent wasn't designed in a lab. EMPClaims built it to solve real problems in our own RCM operations - where our team manages eligibility for thousands of patients across hundreds of payer plans every day. Once we saw the impact on accuracy, speed, and staff satisfaction internally, we knew our customers needed it too.
Key proof points:

Key proof points

Under 2 minutes per patient (complex cases: 2-5 min) Compared to manual? It often doesn't get done at all. Full audit trail for every eligibility interaction Multi-payer, multi-plan - handles the real-world complexity of your payer mix.

Under 2 minutes per patient (complex cases: 2-5 min)

Compared to manual? It often doesn't get done at all

Full audit trail for every eligibility interaction

Multi-payer, multi-plan - handles the real-world complexity of your payer mix

Transparency / No Black Box

Full Visibility. Every Step.

Every action the Eligibility Agent takes is logged, visible, and auditable. The live agent window shows exactly what's happening in real time - which portal it's checking, what data it found, what changes it recommends. Your staff isn't trusting a black box. They're working alongside an intelligent copilot that shows its work.
Integration / How You Get It

Part of the EMPClaims Revenue Command Center

The Eligibility Agent isn't a standalone tool you plug in and pray. It's a fully integrated capability within the EMPClaims RCM platform - configured specifically for your practice's payer mix, plan portfolio, and EMR setup. We handle the complex onboarding of your plans so your front desk gets a seamless experience from day one.

Chrome extension activates within your existing EMR workflow

Works with leading PM/EHR systems

Every plan vetted and onboarded by the EMPClaims team

HIPAA compliant, SOC 2 Type II certified

Stop Losing Revenue at the Front Desk

See how the Eligibility Agent works in your practice. Schedule a demo with our team.
Schedule a Demo
Talk to an RCM Specialist
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