Your billers do not spend the day billing
They spend it logging in, re-keying, waiting on hold, and finding out about denials a month late. Ask the team. This is the actual day.
The 40-login morning
The day starts with a password spreadsheet: Availity for the Blues, the UHC and Optum portals, two state Medicaid portals, the clearinghouse, the EHR, each with its own MFA prompt and 15 minute session timeout. Your most experienced biller spends the first hour getting in, and gets logged out again by lunch.
Swivel-chair data entry
Member ID out of Epic, into the payer portal, character by character. Auth number off the fax confirmation, back into the chart. Eligibility response pasted into the PM notes field. One transposed digit becomes a CO-31 three systems later.
Hold music as workflow
Prior auth status means 40 minutes on hold to hear that it is still in review, call back Thursday. Claim status means the same portal checks, payer by payer, every morning. Industry surveys consistently put prior auth at hours of staff time per clinician per week, and none of it is judgment work.
Denials you learn about 30 days later
The claim went out clean, or so it seemed. Then the 835 lands weeks later: CO-197 no auth on file, PR-204 not covered, and the appeal window (and, with some payers, the corrected-claim window) has been closing the whole time. Industry-wide, initial denial rates run 10 to 15 percent, and most denied claims are never reworked at all.
It works the screen, so your team does not have to
Any EHR, any payer portal, any clearinghouse UI, any fax queue. No interface project, no waiting on a payer API that will never ship.
RPA scripts break the day Availity rearranges a menu, and they fail silently. EDI and API projects take quarters, carry per-connection fees, and still never reach the long tail: the payer portal with no API, the fax-back auth, the legacy PM system. Or you add headcount, onshore or offshore, doing the same clicks at the same error rate.
Coasty reads the screen, acts through mouse and keyboard, verifies the result, and recovers when the portal does something unexpected. It is the same loop a careful biller runs, on every step, with a screenshot recorded for each one. Epic and athenahealth work queues, Availity and Optum portals, Waystar and Trizetto edit screens, fax queues: if a biller can drive it from a screen, Coasty can work it, no interface project first. It uses accounts you provision, handles MFA through your identity controls, and where a real interface exists it connects natively instead of clicking.
This loop runs on every step. It is why Coasty is #1 on OSWorld below.
Runs the systems you already run
The EHRs and practice management systems your team lives in, and the payer portals and clearinghouses that never shipped an API.
No integration or partnership required. These are the screens billing teams already work; if a biller can drive it from a screen, Coasty can work it, with payer-facing submissions gated behind your approval.
Benchmarked #1 worldwide
85.60% on OSWorld, the hardest benchmark for AI agents that use real computers
85.6% from our in-house model, with full results and traces published on GitHub.
82.81% from our public model, independently verified on the official OSWorld leaderboard.
The team's task list, actually worked
Nine workflows your billing team runs today, front to back of the revenue cycle. Coasty runs the clicks, gated on every payer-facing submission. Your people keep the judgment calls.
Eligibility and benefits verification
Pulls tomorrow's schedule from the PM, checks each payer via portal or 270/271, and writes copay, deductible remaining, and plan flags back to the chart. Terminations and plan changes surface before the patient is in the chair, when they still cost nothing to fix.
Prior auth submission and status chasing
Gathers the clinical documentation your clinicians specify for each auth type and keys the request into the payer portal or fax workflow; the packet and the submission both wait for staff approval. It then checks status daily, escalates anything pending past the payer's stated turnaround, and lands the auth number and validity dates in the exact EHR field your billers expect.
Registration QA
Compares demographics, subscriber IDs, and plan codes against the card image and the payer's eligibility response. Catches transposed member IDs, subscriber mismatches, and stale plans, the errors that come back a month later as CO-31 and CO-22.
Charge capture and claim QA
Reconciles encounters against posted charges daily, flags unbilled visits, missing units, and modifier gaps, and queues code questions for your coders before the 837 goes out. It assists the coder. It does not code over them.
Claim scrubbing and clearinghouse edits
Works the Waystar or Trizetto rejection queue the day it appears: reads the edit, fixes the payer ID or subscriber field, submits the required attachment and sets the PWK reference, and resubmits. It logs the root cause so the same edit stops recurring; every edit cleared pre-submission is a downstream touch you never pay for.
837 submission and timely filing watch
Batches and submits claims, confirms clearinghouse acceptance, and tracks every unbilled or rejected claim against each payer's filing window, working the oldest first. Anything drifting toward a deadline is escalated by name, with the clearinghouse acceptance report (999/277CA) filed alongside a timestamped screenshot if a payer later disputes the date. An avoidable CO-29 is pure write-off, and it ends when nothing sits unwatched.
Claim status follow-up
Works the follow-up queue on portals instead of phones, checking status payer by payer on a cycle no phone-based team could match. Each response is documented verbatim in the PM note, and claims that appear to need a human call are flagged so your team decides where to spend phone time.
Denial triage and appeal packets
Reads each 835 and buckets by group code and CARC (CO-197, CO-50, PR-204) and the RARCs that explain them, then routes by root cause and dollar value. It assembles the appeal packet with records, portal screenshots, and the payer's own policy language. A biller approves before anything files, and the small-balance appeals that never penciled out now get worked.
ERA posting and underpayment recovery
Posts 835s, reconciles paid against expected allowable from your contract terms, and flags underpayments, silent downcodes, and takebacks for recovery. Secondary claims that do not cross over automatically go out as soon as the primary posts, with the primary remit attached; crossovers are verified rather than duplicated.
The lines on your board deck
Coasty does not invent a new dashboard metric. It moves the ones you already report: days in A/R, first-pass yield, initial denial rate, cost to collect.
That line is mostly labor performing work that payer portals force to be manual, and it runs meaningfully higher on the professional side. When an agent absorbs the eligibility runs, status pulls, and edit queues, the marginal cost of a touch collapses.
Appeals die on arithmetic: an hour of biller time against a small balance loses money on paper. When drafting a CARC-coded appeal packet takes minutes of review instead of an hour of assembly, claims that were quietly written off become claims that get worked.
A claim paid on first submission costs a fraction of one that bounces. Eligibility checks, registration QA, and scrubbing running on every encounter push clean-claim rate directionally up, and each point is rework labor you never spend.
Days in A/R is mostly waiting: the gap between submission and the next touch. When status checks, edits, and posting run overnight, mornings start with triaged exceptions instead of raw queues, and A/R comes down the unglamorous way.
Directional by design. Your payer mix, contract terms, and baseline denial rate set the size of each move. None of these figures are Coasty customer measurements; they are the industry-typical levers a revenue-cycle leader already tracks. Baseline your numbers, then hold the pilot to them.
Trust is an architecture, not a promise
Why a healthcare organization can actually deploy this, in the order your security review will ask.
Coasty can deploy into your own environment and drive your systems from inside it. Screenshots and logs are stored inside your walls, and the only data that leaves is the inference call made with the model keys you choose, under your own agreement (and BAA) with that provider. There is no Coasty data lake with your patients in it.
Gated steps stop and wait: claim submissions, appeal filings, auth requests, adjustments. A named biller reviews the prepared work on screen and approves, edits, or rejects it before anything reaches a payer; read-only checks like eligibility and status run automatically and are fully logged. Coding and clinical judgment stay with your people.
Every run is a replayable record: what was on screen, what was clicked, what the portal returned, retained under your own access controls and retention policy. When a payer disputes a filing date or a compliance officer asks who touched a claim, you pull the run, not people's memories.
- 08:03:11Open payer portal (Availity)08:03:11Verified
- 08:03:19Verify eligibility and benefits08:03:19Verified
- 08:03:24Read prior auth requirement08:03:24Verified
- 08:03:31Submit authorization request08:03:31Awaiting approval
- 08:03:52Write auth number to the EHR08:03:52Verified
Available as a dedicated deployment in your VPC, behind your firewall and your identity controls.
Inference runs on model keys you own, under your own provider agreement, with a BAA where screen content may contain PHI.
Screenshots, credentials, and logs stay inside your walls; the only outbound flow is the model call you control.
One screenshot per action, one approval record per gated step, one replayable log per run.
Put it on a queue you already dread
Bring a denial backlog, an eligibility batch, or a status-check queue. Watch Coasty work it on your own portals, fully gated, with your team approving every payer-facing step, and measure the result against your own baseline.
No integration project to start. Approval gates on day one. Your perimeter, your keys.