Substrate automates claim status checks with Stedi
Substrate builds AI agents for revenue cycle management (RCM). Their Substrate Claim Status agents connect to a provider's Electronic Health Record (EHR) and automate the work that turns a patient visit into a payment.
Much of that work revolves around claims – checking their status, handling denials, and posting payments. Most customers see a 75% reduction in manual collections work.
Challenge
For a provider, a claim represents a potential payment. When they submit a claim but can't track what happens next, that payment might as well have gone into a black hole. Did the payer receive it? Is it in adjudication? Was it approved or denied?
Browser agents are one way Substrate tracks a claim's status. Their agents log into payer portals, look up claims, retrieve the claim status, extract important information, and then insert it back into the client’s EHR.
It works, but browser agents can take some time. Previously, Substrate's browser-based claim status checks took 1-4 minutes each. For EHR platforms processing thousands of claims, checking all their claims could take days.
Substrate set out to speed up those timelines with their claim status agent.
"Browser agents alone weren’t enough," says Ayo Omojola, co-founder of Substrate. "We wanted to use the best tools for the job. Not every claim status requires someone to log into a portal."
"Browser agents alone weren’t enough. We wanted to use the best tools for the job."
Solution
Substrate augmented their browser agent with Stedi's Real-Time Claim Status API.
Stedi's API returns the same response structure regardless of payer. Substrate could use the API to get a claim status from a wide range of payers.
Substrate got direct access to Stedi's team through a dedicated Slack channel. When payer-specific errors came up, Stedi could help diagnose and resolve them directly.
With Stedi's support, Substrate built their claim status agent with payer-specific logic — handling the variations in payer IDs, NPIs, and tax IDs that determine whether a check succeeds.
The Substrate Claim Status Agent also uses Stedi's Real-Time Eligibility API to correct patient and payer data when checks fail.
"Our raw success rate when we ran just a claim status check was around 20%," says Ayo. "With Stedi's range of APIs, the Substrate Claim Status agent takes claim status success rates north of 60%. Stedi has also enabled us to onboard gigantic enterprise customers and return high-quality results within 24 hours of going live."
"Stedi has enabled us to onboard gigantic enterprise customers and return high-quality results within 24 hours of going live."
Results
Substrate's agents now process millions of claims per year.
Stedi's real-time status checks are a key part. When Stedi returns a definitive claim status response – accepted, paid, or denied – Substrate skips the browser agent step entirely. That means a check that used to take minutes now runs in seconds.
Browser agents are now reserved for the cases that actually need them: appeals, edge cases, claims that need deeper investigation, or payers that don’t support claim status checks. The rest resolve automatically.
"We're building Agentic AI for RCM teams to help doctors and nurses get paid fairly for the care they deliver," says Ayo. "That only works if everything underneath is solid. Stedi gives us that."
"We're building Agentic AI for RCM teams to help doctors and nurses get paid fairly for the care they deliver. That only works if everything underneath is solid. Stedi gives us that."
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