Hipp Agentic Claims Resolution: Off Hold, Back to Care

When a denial reason is vague, a policy is unclear, or information is missing, resolving an insurance claim means getting a payer on the phone. At one behavioral health practice we visited, working through six claims in an hour counted as fast, and a single claim could take upwards of 45 minutes on hold, navigating phone menus and getting transferred. Multiply that across dozens of denials, and billers spend their days on calls while clinics quietly lose revenue they already earned.

Agentic Claims Resolution, part of Hipp's agentic billing platform, turns that follow-up into an AI-powered workflow that diagnoses issues, plans next steps, and carries them out.

A unified Kanban board surfaces denied claims and prioritizes what needs attention. Hipp analyzes denial codes, claim data, and payer context to build a resolution plan that billers can review, edit, and approve. Then Hipp does the work. It calls the payer itself, with a live transcript the biller can listen to and take over at any moment. It also updates fee schedules and prepares corrected claims and appeals, showing each change side by side for approval.

We designed the AI to work inside the tools billers already know, never out of sight. Every action lands in an auditable activity log, and nothing is submitted without human approval, so people stay focused on decisions while the repetitive work runs within guardrails.

By taking on hours of payer calls and follow-up, Hipp makes sure clients' care is properly reimbursed and practices get every dollar they earned. Providers get more time to spend with the children and families they serve.