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QuickIntell · Payer portal automation bots

Payer portal bots for every payer portal your team logs into

QuickIntell has payer portal automation bots for the payer portals your billers work in every day. Each bot signs in the way your staff do, completes the lookup or submission, and writes the result back to your billing system or a review log. Read the bot profiles for what each one automates, then browse the directory of 300 payers and their portals to find yours.

Request a bot for your payer mix

Share your workflow and systems. Do not send patient records through the public contact form.

Where this fits

Use a bot when a payer has no usable API for the task, or when the portal is the only place a status, document or authorization is available. Portal bots complement Availity and Stedi API connections and the QuickRCM Automation and Agent Builder modules; they do not replace a supported direct connection when one exists.

From your payer mix to a running bot

  1. Map the payer mix

    List the payers and portals your team logs into for eligibility, claim status, authorizations and appeals. Match them against the portal directory and existing bot profiles on this page.

    Browse payer guides

  2. Choose the run form

    Hosted API bots run on QuickIntell infrastructure. Desktop bots run on a practice laptop with your existing logins. In-platform agents run from QuickRCM with an approval gate before any write.

    See Agent Builder

  3. Validate read-first

    Every bot starts with lookups only. Review extracted fields, exception handling and the audit trail on approved test accounts before write-back is enabled.

  4. Enable write-back

    Turn on comments, notes, tasks or document uploads into Raintree, Brightree, eClinicalWorks, PrognoCIS or your billing system once the read-only run is verified.

    Read how portal tasks are controlled

Coverage across payer portals and clearinghouses

Availity Essentials is the largest single surface: one hosted bots API handles eligibility, claim status, claim submission, appeals search, prior authorization for more than twenty named payers and credentialing lookups for every payer connected through Availity. Direct portal bots cover UnitedHealthcare, Sharp, Humana Military (TRICARE), Blue Shield of California, Kaiser eligibility reports and payer programs such as Optum Practice Assist and Zephyr.

Medicare, Medicare Advantage, Medicaid managed care, Blue plans, commercial payers, third-party administrators and workers' compensation carriers are all represented in the portal directory. Where a payer routes through Availity, Stedi or Waystar, the corresponding bot or API tool covers it; where a payer keeps a standalone portal, a dedicated bot or an Agent Builder template is used.

How the bots run

Credentials stay with your organization. Desktop bots use the logins your staff already hold and pause for multi-factor prompts; hosted and in-platform bots keep secrets in an encrypted vault with per-credential MFA method, session limits, allowed hours and static-IP controls. Nothing is stored in the bot itself.

Every run produces evidence: structured results, a spreadsheet or database log, screenshots on failure and an audit trail of what was read and what was written. Write-back is deliberately narrow, for example a claim-status bot updates the billing system only for paid or in-process claims and leaves denials for a human.

Write-back targets

Bots write comments, tasks, billing alerts and documents into Raintree, Brightree, eClinicalWorks, PrognoCIS and InSync today. MEDENT and OpenEMR are read from for extraction and appointment sync, not written to. The QuickRCM platform records every portal task against the patient, claim or authorization it belongs to.

Each write-back is validated on your installation before go-live; portal layouts and EHR versions differ, and the bot's field mapping is confirmed against your screens rather than assumed.

Bot profiles

What each bot signs into, what it automates, where it writes results and how it runs.

Clearinghouse bots

One surface, every connected payer.

Availity Essentials Bots API

A hosted service that operates Availity Essentials on your behalf for every payer reachable through Availity, exposed as REST endpoints your systems can call.

Portals and systems
  • Availity Essentials (apps.availity.com / essentials.availity.com)
What it automates
  • Eligibility and benefits for any Availity payer: coverage status, effective and termination dates, copay, deductible remaining, out-of-pocket maximum, plan name and type
  • Enhanced claim status: status, adjudication date, billed and paid amounts, patient responsibility, check or EFT number, CARC and remark codes
  • Professional claim submission
  • Appeals worklist search
  • Prior authorization requests for Aetna Commercial and Medicare, Aetna Better Health plans, Allina Health Aetna, Banner Aetna, Sutter Health Aetna, Texas Health Aetna, Innovation Health, Ambetter, Oklahoma Complete Health, WellCare of Oklahoma, Premera Blue Cross, BCBS Oklahoma, Wellpoint, UniCare, HealthLink, Prominence Health, Priority Partners, Johns Hopkins Employer Health Programs, Carelon Behavioral Health, Humana and WebPTA
  • Credentialing lookup by NPI and specialty: status, participating payers and locations
Runs as
Hosted REST API (eligibility, claim status, claims, appeals, authorization, session and health endpoints) with a shared, session-managed browser; database-backed queue mode for batch work.

Availity API agent tools

Availity Partner API workflows packaged as tools that QuickIntell agents and compatible AI clients can call directly, without a browser.

Portals and systems
  • Availity Partner API
What it automates
  • Coverages (eligibility and benefits)
  • Claim status
  • Service reviews: create and list prior authorizations, check whether authorization is required, attach documents
  • Payer list, dental claims, professional and institutional care-cost estimators, care reminders and member card lookup
Runs as
Containerized Model Context Protocol server used by the denial resolver and RCM chat agents.

Payer portal bots

Dedicated bots for portals that stand alone.

UnitedHealthcare and Sharp claim-status bot

Works invoice by invoice from your billing system, looks each claim up on the payer portal and records the outcome with a full audit trail.

Portals and systems
  • UnitedHealthcare Provider Portal (One Healthcare ID)
  • Sharp EpicCare Link provider portal
  • Brightree billing system
What it automates
  • Reads invoices from an input spreadsheet and checks e-claim submission in Brightree
  • Looks up claim status, paid amount, dates and denial codes on the payer portal
  • Classifies each claim as paid, denied, misdirected, in process, rejected or pending
  • Compares the portal received date with the latest denial date so only newer information is acted on
  • Logs every result and note to a tracking spreadsheet for human review
Write-back
Writes a work note back to Brightree only for paid or in-process claims; denials stay in the review log.
Runs as
Licensed Windows desktop application with screen-level automation and OCR; staff complete portal logins and MFA, the bot runs the batch.

Medicare eligibility bot

Clears the Medicare pending queue in Raintree by classifying coverage and writing the Part B figures your billers need.

Portals and systems
  • Medicare eligibility via clearinghouse results
  • Raintree practice management
What it automates
  • Classifies each patient as Traditional Medicare, California QMB, Medicare Advantage, Medicare Secondary or inactive
  • Captures Part B deductible, amount met, remaining and coinsurance
  • Creates follow-up tasks for Medicare Advantage and secondary cases
  • Reads and reports pending-authorization statuses
Write-back
Writes a structured eligibility comment and tasks into Raintree.
Runs as
Licensed Windows desktop application driving Raintree through Azure Virtual Desktop, with model-assisted OCR and a batch results file.

Aetna eligibility bot

Aetna Commercial and Medicare eligibility through Availity Essentials with location-specific authorization notes.

Portals and systems
  • Availity Essentials — Aetna (Commercial & Medicare)
  • Raintree practice management
What it automates
  • Eligibility and benefits capture per appointment
  • Location-specific authorization and referral comments
Write-back
Writes eligibility and authorization comments into Raintree.
Runs as
Licensed Windows desktop application; same runtime as the Medicare bot.

Blue Shield of California bot

Blue plan eligibility plus member-prefix claim routing for California.

Portals and systems
  • Availity Essentials (California)
  • Blue Shield of California Claims Routing Tool
  • Raintree practice management
What it automates
  • Eligibility captured from the Availity results page
  • Member-prefix routing lookup so claims go to the responsible Blue plan
Write-back
Writes eligibility results into Raintree.
Runs as
Licensed Windows desktop application.

Blue Cross Blue Shield of Texas bot

BCBSTX eligibility through Availity Essentials.

Portals and systems
  • Availity Essentials — BCBSTX
  • Raintree practice management
What it automates
  • Eligibility and benefits capture per appointment
Write-back
Writes eligibility results into Raintree.
Runs as
Licensed Windows desktop application.

Arizona Medicaid bot

Multi-plan Medicaid eligibility for Arizona through Availity Essentials.

Portals and systems
  • Availity Essentials — AHCCCS, Mercy Care, Mercy Care RBHA and Arizona Complete Health
  • Raintree practice management
What it automates
  • Identifies the responsible plan and captures eligibility per appointment
Write-back
Writes eligibility results into Raintree.
Runs as
Licensed Windows desktop application.

Kaiser Permanente eligibility bot

Kaiser eligibility, copay and authorization capture from the clearinghouse eligibility report.

Portals and systems
  • Kaiser Permanente eligibility via Waystar reports
  • Raintree practice management
What it automates
  • Generates or reuses the Kaiser eligibility report
  • Captures eligibility, copay and the authorization field
Write-back
Writes results into Raintree.
Runs as
Licensed Windows desktop application.

TRICARE (Humana Military) bot

TRICARE coverage extraction from Humana Military provider self-service with authorization notes and pending-auth reporting.

Portals and systems
  • Humana Military provider self-service portal
  • Waystar eligibility reports
  • Raintree practice management
What it automates
  • Coverage and benefit extraction per appointment
  • Authorization comments and pending-authorization reporting
Write-back
Writes coverage and authorization comments into Raintree.
Runs as
Licensed Windows desktop application.

HCC attestation document automation

Collects pending HCC attestation and patient-profile documents from payer programs and files them into the chart with an alert for the clinician.

Portals and systems
  • Zephyr (One Healthcare ID)
  • Optum Practice Assist
  • PrognoCIS and InSync EHRs
What it automates
  • Downloads pending attestation and patient-profile PDFs
  • Verifies patient identity before filing
  • Tracks results in a shared tracker with email notifications
Write-back
Uploads the PDF to the patient chart and adds a pending-attestation alert or note.
Runs as
Scheduled server job; staff complete MFA through a remote session.

EHR-side eligibility bots

Bots that run inside the EHR and call payer connections behind the scenes.

QuickIntell Eligibility Pro for eClinicalWorks

Verifies insurance for next-day appointments inside eClinicalWorks and posts a formatted eligibility comment to each patient's billing alert.

Portals and systems
  • eClinicalWorks cloud
  • QuickIntell eligibility API (payer routing across Availity and Stedi, 12,000+ payer aliases)
What it automates
  • Pulls the Next Day Appointments report and each patient's date of birth
  • Runs an eligibility check per patient
  • Tracks successes, failures and unmatched payers in separate spreadsheets
Write-back
Writes a structured eligibility comment into the eClinicalWorks Billing Alert.
Runs as
Windows desktop application with a settings screen; one API key per practice.

MEDENT eligibility extraction bot

Reads patient and insurance details from MEDENT screens and hands them to QuickIntell workflows.

Portals and systems
  • MEDENT desktop EHR
What it automates
  • Extracts demographics and insurance details from eligibility and insured screens
  • Posts structured data to the QuickIntell voice-agent dashboard
Runs as
Windows desktop application with vision-model screen reading and local run tracking.

In-platform agents

Configured inside QuickRCM with approval gates.

QuickRCM Agent Builder portal templates

No-code portal agents you configure inside QuickRCM from ready templates, with approval gates before any write.

Portals and systems
  • Availity Essentials (eligibility, claim status, ERA download)
  • Any payer portal (prior authorization submission, fee schedule download, denial reasons extract)
  • CMS claim submission
  • CAQH ProView attestation renewal
  • NPPES NPI registry lookup
  • PECOS enrollment verification
What it automates
  • Nine step types: navigate, act, extract, observe, wait, condition, loop, approval gate and sub-agent
  • Credential vault with SMS, email, authenticator, security-question, push and hardware-token MFA handling
  • Session limits, allowed hours and static-IP controls per credential
  • Execution history and audit log for every run
Runs as
Inside the QuickRCM platform (Agent Builder module).

QuickRCM portal task automation

Queued portal tasks with human approval, run against payer, credentialing and EHR portals from the QuickRCM automation module.

Portals and systems
  • Payer portal eligibility (any authorized HTTPS portal)
  • Payer enrollment submission and status checks
  • CAQH attestation, directory verification and roster submission
  • OpenEMR and QuickIntell EHR tasks (demographics, appointments, insurance, charges, clinical notes)
What it automates
  • Task queue with pending-approval, running, completed, failed, blocked and cancelled states
  • Read-first validation before any write is enabled
  • Encrypted credential vault and full audit trail
Runs as
Inside the QuickRCM platform (Automation module).

Every payer portal we cover

300 payers across 275 distinct portal hosts from the QuickIntell payer registry, grouped by program type. Several payers share a portal (for example UnitedHealthcare plans on uhcprovider.com). Each entry links to the payer guide with its portal entry point, timely filing and appeal levels.

Commercial payers
Eligibility, claim status, prior authorization and appeals through the payer's own provider portal or its Availity Essentials workflows.
Blue Cross Blue Shield plans
Plan-specific eligibility and claim routing through Availity Essentials and the Blue plan's provider tools, with member-prefix routing lookups.
Medicare Advantage plans
Coverage classification, benefits capture and authorization comments written back to your billing system.
Medicaid managed care plans
State-plan eligibility and benefits through Availity Essentials or the plan portal, including multi-plan states.
Medicare and MAC portals
Traditional Medicare, QMB, Advantage and secondary classification with Part B deductible and coinsurance capture.
TRICARE, VA and other government programs
Coverage extraction and authorization notes from program portals such as Humana Military provider self-service.
Third-party administrators
Administrator portal lookups scoped to the employer plan on the member ID card.
Workers' compensation and auto medical
Claim-specific status and document retrieval from the carrier or bill-review vendor portal.

Clearinghouse, credentialing and government surfaces

  • Clearinghouse portal

    Availity Essentials

    Eligibility, claim status, claim submission, appeals, prior authorization and credentialing lookups for every Availity-connected payer.

  • Clearinghouse API

    Availity Partner API

    Coverages, claim status, service reviews, attachments, payer list and estimators as agent tools.

  • Clearinghouse API

    Stedi

    Payer routing for eligibility and claims behind the QuickIntell eligibility API.

  • Clearinghouse portal

    Waystar

    Eligibility reports read by the Medicare, Kaiser and TRICARE bots.

  • Credentialing & enrollment

    CAQH ProView

    Attestation renewal and profile completeness checks.

  • Government

    CMS PECOS and NPPES

    Enrollment verification and NPI registry lookups.

Payer portal directory

Search by payer, portal domain or state, or filter by portal family. Every portal listed is covered by a bot, an Availity or Stedi connection, or an Agent Builder template.

Showing 300 of 300 payer portals.

Commercial payers

Blue Cross Blue Shield plans

Medicare Advantage plans

Medicaid managed care plans

Medicare and MAC portals

TRICARE, VA and other government programs

Third-party administrators

Workers' compensation and auto medical

Bring these details to a workflow review

  • Payers and portals in scope, with the transaction each needs
  • Existing clearinghouse connections (Availity, Stedi, Waystar) and portal accounts
  • Billing system or EHR that should receive results
  • Approval owner for write-back and exception handling
  • Volume per day and preferred run form (hosted, desktop or in-platform)

Common questions

Which payer portals do you have bots for?

Availity Essentials (covering every Availity-connected payer), UnitedHealthcare Provider Portal, Sharp EpicCare Link, Humana Military provider self-service for TRICARE, Blue Shield of California, Aetna, Blue Cross Blue Shield of Texas, Arizona Medicaid plans, Kaiser Permanente eligibility, Medicare, Optum Practice Assist and Zephyr, plus Agent Builder templates for CMS, CAQH ProView, NPPES and PECOS. The directory on this page lists every payer portal in our payer registry.

Do the bots need our portal logins?

Yes. Bots operate the portal under an account your organization is authorized to use. Desktop bots use the staff member's own session and pause for MFA; hosted bots keep credentials in an encrypted vault that your administrators control.

Can a bot write back into our billing system?

Yes, once the read-only run is verified. Current write-back targets include Raintree, Brightree, eClinicalWorks, PrognoCIS and InSync, and the QuickRCM platform for in-platform agents.

What if my payer is not listed?

If the payer routes through Availity, the Availity bots API already covers it. Otherwise a dedicated bot or an Agent Builder template is scoped for that portal; share the portal and transaction and we will confirm the run form.

Confirm the scope for your environment

Availability depends on the configured modules, interfaces, permissions and validated workflow. Talk with the team about your current systems, review responsibilities and required outcomes.

Request a bot for your payer mix