Substrate automates claim status checks with Stedi
Substrate builds AI agents for revenue cycle management (RCM). The Substrate Claim Status agents connect to a provider's Electronic Health Record (EHR) and handle the work that turns a patient visit into a payment.
Most of that work revolves around claims – checking their status, handling denials, and posting payments.
Substrate's agents automate that work – with a 75% reduction in manual collections for most customers.
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 processing, was it approved or denied?
One way Substrate tracks a claim’s status is with browser agents. Agents log into the payer’s portals, look up the claim, retrieve the claim’s status, extract the information as structured data, and normalize and insert it back into the client’s practice management system.
It works, but browser agents can take some time and are not always necessary. Checks took 1-4 minutes each. For EHR platforms processing thousands of claims, that could take days.
Substrate set out to automate that follow-up with their claim status agent. But the agent needs consistent, structured responses to work.
"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 standardized responses with the same response structure regardless of payer. Substrate could use the API to get a claim status from a wide range of payers.
Stedi also gave Substrate a dedicated Slack channel with direct access to Stedi's team. When payer-specific errors came up, Stedi could help diagnose and resolve them directly.
With that reliability and support, Substrate built their claim status agent. It applies payer-specific logic and retries across different payer IDs, NPIs, and tax IDs.
The Substrate Claim Status Agent also uses Stedi's Real-Time Eligibility API to correct patient and payer data when checks fail. It fixes the claim status matching problem at the source with better data rather than just retrying the check.
"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 agent now processes millions of claims per year.
When Stedi returns a definitive claim status response, a claim confirmed, 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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