HIPAAReady workflows
PHI-aware operating patterns and BAA-ready implementation scope.
Healthcare payer AI
AI agents for healthcare payer operations
Soteria deploys governed AI agents for health plans, TPAs, stop-loss teams, captives, and benefits operations. Automate the work that slows teams down while keeping reviewers, source evidence, and audit trails in control.
55%automation rates in production pilots
24/7payer support and document intake
UShealthcare payer operations focus
Eligibility checksBenefit questionsRenewal packet intakeMissing-item detectionPlan document lookupClaim-status supportEnrollment exceptionsReviewer summariesBroker follow-upAudit-ready handoffsEligibility checksBenefit questionsRenewal packet intakeMissing-item detectionPlan document lookupClaim-status supportEnrollment exceptionsReviewer summariesBroker follow-upAudit-ready handoffs
Trust layer
Controls that look and work like healthcare infrastructure
Security and compliance are presented as product surfaces, not footnotes. Soteria keeps the automation layer governed, source-linked, and reviewer-aware.
SOC 2Control aligned
Access control, audit logs, change history, and operational review points.
CITESource evidence
Answers linked to documents, rules, cases, and workflow events.
HITLHuman review
Approval states for decisions that need human judgment.
The problem
Payer teams are buried in operational busywork
Renewal packets arrive incomplete. Support teams search across plan documents and cases. Reviewers need cited evidence before decisions can move. Soteria gives each workflow a governed agent that prepares the work before a human needs to step in.
More volume
Member, provider, broker, and renewal requests keep rising without matching headcount.
More systems
Useful context is spread across emails, document stores, queues, CRMs, and plan files.
More scrutiny
Healthcare operations need source evidence, approvals, and traceability for sensitive actions.
One agent platform. Every payer workflow.
Start with the highest-friction queue, prove acceptance with real packets and plan data, then expand across support, renewals, eligibility, and plan operations.
Support Agent
Answers member, provider, and broker questions with plan-grounded citations.
Learn moreRenewal Ops Agent
Turns census files, loss runs, questionnaires, and emails into review-ready packets.
Learn morePlan Agent
Finds plan language, eligibility rules, and case context for source-linked decisions.
Learn moreReviewer Assist
Surfaces missing items, next steps, summaries, and audit evidence for human review.
Learn moreBuilt for regulated healthcare work
The product experience is intentionally controlled: agents cite sources, draft decisions, route exceptions, and preserve audit context.
Source-linked outputs
Every answer points back to the document, file, rule, case, or workflow event behind it.
Human approval states
Sensitive actions can stay draft-only, review-required, or fully automated by workflow.
Operational audit trail
Inputs, outputs, owner changes, reviewer corrections, and handoffs remain traceable.
System-fit deployment
Soteria works around existing queues, CRMs, document stores, and data systems.