BoMed Clinical · In development with design partners

Insurance calls without the hold music.

Pediatric specialty clinics spend 5–15 hours per provider, per week, on insurance phone calls. We're building the AI agent that does them for you — and writes the outcomes straight back to your EHR.

Join the pilot list

The math is brutal.

5–15 hrs

per provider per week on insurance calls

$30–100

staff cost per call

15–30%

of prior auths denied initially

Months

families wait for their kid’s care

Every hour your team spends on hold is an hour they aren't spending with patients. Every denied prior auth is a child waiting for therapy, equipment, or evaluation that's clinically indicated and contractually covered.

What we handle.

Eligibility verification

Confirm coverage, copay, and benefits before the visit. Cuts the front-desk-to-payer phone loop entirely.

Prior auth status

Follow up on submitted PAs without your staff sitting on hold for 40 minutes per case.

Prior auth submission

Initiate new prior authorizations with the clinical justification pulled per-call from your EHR. Pediatric specialty playbooks built in.

Appeals

Denied PAs get re-submitted with the clinical evidence the payer didn't see the first time.

The wedge

Built for pediatric specialty Medicaid complexity.

Generic AI insurance callers handle adult oncology and PBM workflows. They don't know how to fight for a kid's AAC device on Vermont Medicaid, argue ABA medical necessity for a 4-year-old in Texas, or navigate Katie Beckett waiver criteria. We do.

✓Autism therapies — ABA CPT 97153 / 97155 / 97156, state-by-state coverage

✓CP equipment — AAC devices (HCPCS E2510), AFOs, custom wheelchairs

✓Speech therapy with Medicaid waivers — Katie Beckett, Family Opportunity Act

✓Early-intervention crossover with school IEP services

✓Pediatric ICD-10 codes payers underwrite differently than adults

✓State-specific Medicaid managed care plan logic

PHI architecture

We never store your patients' data.

BoMed Clinical pulls the minimum-necessary slice from your EHR at the start of each call, holds it in process memory only, and writes the outcome directly back to your EHR. The EHR is the system of record. We're a stateless passthrough.

✓No transcripts stored. No recordings stored. No clinical notes cached.
✓Outcomes written back to your EHR as FHIR Communication / Task / DocumentReference
✓HIPAA-aligned by design — audit logs are the only persistent record
✓Family consent captured per-patient through the Bolo trust layer

EHR integrations.

PointClickCare is our first planned integration, via SMART on FHIR Backend Services — in development with design partners. Athena, Epic, and eClinicalWorks follow. If you're on a USCDI-compliant EHR, you're already most of the way there.

Join the pilot list.

We're working with a small number of pediatric specialty practices to shape the product. If you're losing too many hours to insurance calls and want to see if we can help, reach out.

Email us about the pilot

alison@bomed.ai