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Introducing the next phase of Sovica: the architecture for agentic care
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Automatically raise a claim when a visit is completed.

Turn each finished note into a claim that’s checked against the insurer’s rules.

Use templateWorkflows docs
TriggerAppointment status changedDataA visit’s status changesConditionConditionsStatus is CompleteCreate claimClaimsCodes from the visit noteCheck insurer rulesClaimsSend clean, flag the rest

Setup guide

Overview

Work that’s done but never claimed is the most expensive kind. This template builds the claim from the visit note, checks the insurer’s rules and passes anything uncertain to a named person.

Prerequisites

These are the pieces we suggest having ready before you switch this workflow on. Your clinic may set things up differently, so treat the list as a guide.

  • Your insurers set up in Sovica

How to use this template

Once it opens, you’ll see the blocks joined up in order.

  1. The Appointment status changed trigger runs when a visit’s status changes. Choose the appointment types you bill to insurers, and leave out anything patients pay for themselves.
  2. The Condition block carries on only for finished visits, so nothing is claimed for a visit still under way:
    {Status} [is] "Complete"
  3. The Create claim block raises the claim, with codes taken from the visit note and the policy from the patient’s record.
  4. The Check insurer rules block sends what passes and flags the rest for your billing team to review.

Workflows FAQ