Frequently Asked Questions

Calvient is a healthcare operations AI platform that centralizes inbound work — faxes, referrals, prior authorizations, records requests, and patient messages — into owned queues, then uses AI agents to classify, route, and complete the repetitive steps. It serves specialty practices, primary care, FQHCs, and hospitals and health systems, and works alongside major ambulatory EHRs. Explore the platform or agentic AI.

Calvient replaces the pile of single-purpose tools and manual tracking that healthcare operations teams juggle: unread fax queues, referrals that stall without follow-up, prior authorizations nobody is chasing, release-of-information backlogs, and patients lost to follow-up. Every inbound item becomes a tracked task with an owner, a status, and a next action — and AI agents handle the repetitive middle so staff focus on judgment calls. See common problems Calvient addresses.

Yes. Most teams start with their highest-pain workflow — often referral management or prior authorization — and expand as they go. Calvient is built as a single platform, so adding workflows does not require a new implementation. Your data, queues, and team structure carry over.

No. Calvient's agents handle administrative and operational work only, such as classifying documents, routing tasks, chasing prior authorizations, sending reminders, and compiling records. Any step that requires clinical judgment is surfaced to staff with full context attached. Calvient does not generate clinical recommendations or make care decisions.

Calvient serves specialty practices, primary care and value-based care teams, FQHCs and community health centers, hospitals and health systems, and healthcare service providers that manage document-heavy operational workflows.

Agentic AI in healthcare refers to AI systems that autonomously execute multi-step administrative workflows in response to defined triggers — without requiring step-by-step human instruction for each action. Unlike chatbots that answer questions, agentic AI agents take action: verifying documents, sending follow-ups, routing tasks, checking eligibility, submitting prior authorizations. They hand off to staff only when a situation requires clinical judgment or exception handling. Read more on agentic AI.

Special Agents are Calvient's library of configurable automation agents. Each agent monitors a queue or inbox, has a trigger condition, a set of automated actions it can perform, and a defined handoff point where human judgment takes over. Examples include an inbox triage agent that classifies and routes incoming documents, a missing-information chaser for incomplete referrals, a prior-auth agent that prepares submissions and tracks payer decisions, and reminder and follow-up agents for patient outreach. See the full agent catalog.

Calvient's agents automate document intake and triage, referral management, prior authorization preparation and tracking, real-time eligibility and benefits verification, appointment reminders and no-show recovery, patient form completion follow-up, release-of-information processing, and queue management with SLA enforcement. Each workflow is covered in depth under use cases.

Each agent has a defined handoff condition configured for its workflow — for example, a case exceeding its SLA threshold despite outreach, an item below the agent's confidence threshold, a non-responsive patient or provider, or any situation requiring clinical judgment. When an agent hands off, it surfaces the item to the right staff queue with the full task history, communications log, and extracted data attached.

Traditional automation (RPA, rule-based bots) follows rigid scripts that break when data changes or edge cases appear. Agentic AI applies judgment within defined parameters — it can interpret unstructured documents, adapt to different payer requirements, and decide which action is appropriate based on context. The key difference is that agentic AI handles variability; traditional automation requires near-perfect data conditions to function reliably.

Calvient automates intake and triage in four steps: it (1) captures every inbound fax, email attachment, form submission, and document upload into one queue, (2) uses AI to classify document type, patient, urgency, and workflow category before staff open the item, (3) extracts key details such as payer, provider, and missing information, and (4) routes, escalates, or auto-closes each item by rule. High-confidence items route without manual review; exceptions surface to staff with context attached. See intake and triage.

Referral intake automation starts with capturing every inbound referral — fax, portal, or direct message — into a tracked queue. Calvient validates completeness against required clinical and demographic fields, flags what is missing, triggers outreach to the referring office to collect it, verifies insurance and network status, and routes the referral by specialty, urgency, or payer. Every referral keeps a status record from intake through scheduling and consult-note return, so nothing stalls silently. See referral management.

Calvient parses incoming records requests — including faxes — to identify the requester, patient, and scope automatically. It classifies the request type (continuity of care, legal, insurance audit, subpoena), checks whether a signed patient authorization is required and holds the release until it is in hand, and logs every release with requester identity, authorization status, documents included, dispatch method, and delivery confirmation. See medical records and release of information.

Large parts of the prior authorization workflow can be automated. Calvient prepares authorization submissions from referral and clinical documentation, tracks payer decisions and deadlines, chases responses, runs real-time eligibility and benefits verification — including deductible, copay, coinsurance, and in-network status — and alerts staff when a decision is due or an appeal window is opening. Staff stay in control of clinical content and final submission review. See prior auth and payer ops.

Automated patient outreach covers appointment reminders, no-show recovery, recall campaigns, form-completion nudges, and post-visit surveys. Calvient sequences the outreach automatically, interprets patient replies, and branches on the response — a reschedule request routes to the access team, a low survey score triggers a staff follow-up task, and non-responders escalate to a different channel or a live call queue. See patient outreach and follow-up.

Instead of staff reading and sorting every fax, Calvient's AI identifies the likely document type — referral packet, records request, payer letter, lab result, authorization document — along with the patient, sender context, and urgency signals. Items land in the right queue already labeled, and high-confidence items can be routed or auto-filed without anyone opening them first.

Calvient integrates with major ambulatory EHR platforms including eClinicalWorks, athenahealth, NextGen Healthcare, ModMed, Veradigm, AdvancedMD, CureMD, and Greenway Health. See the full list of supported EHR environments.

Calvient's agents read workflow state from your EHR, operate within Calvient's operational layer, and write back at defined points — for example, posting digital intake data to the patient record so staff are not re-entering information. Exact field mapping is confirmed during implementation.

No. Calvient works alongside your existing EHR rather than replacing it. It adds the operational layer — queues, task ownership, automation, and reporting — that most EHRs do not provide, without requiring a system migration.

Yes. Calvient is HIPAA compliant with encrypted storage and transport, tenant-level data boundaries, role-based access controls, and full audit logging. A Business Associate Agreement (BAA) is included with every customer agreement. Details are on the security page.

Yes. Calvient maintains a SOC 2 Type II attestation, meaning an independent auditor examined its security controls in operation over time — not just their design. Learn more about Calvient's security practices and responsible AI approach on the customer trust page.

Access is role-based and scoped to your organization. Calvient enforces tenant-level data boundaries, so your data is isolated from other customers, and every access and release is captured in audit logs available for compliance review.

Most teams are operational within a few weeks. The timeline depends on the number of workflows being activated and the complexity of your EHR environment. Calvient's implementation team handles the configuration and works alongside your staff to map workflows before go-live.

Pricing depends on the workflows you activate and the volume of work moving through them. Calvient does not publish list pricing — contact the team for a quote scoped to your workflows, or try the ROI calculator to estimate the impact first.

Request a demo and the team will walk through the workflows that match your operation — typically with your own document types and scenarios rather than a generic script.