AI for Greenway Health Practices: What It Runs

AI for Greenway Health practices works by driving the Intergy and Prime Suite screens your staff already sign into, rather than through a custom integration. A browser agent opens Greenway in a session, reads the registration, scheduling, or worklist screen, decides the next step, takes the action, and writes the result back to the same record. Because it uses the interface a person uses, it does not need an HL7 or FHIR interface or a developer API to reach Greenway Health. In revenue cycle, that means an agent can run insurance eligibility checks, submit and track prior authorizations, follow up on claim status, and read remittance detail, mapping to the standard 270/271, 278, 276/277, and 835 transactions. Voice agents handle the phone work around those screens, such as calling a payer to confirm coverage, and the outcome is recorded in the same Greenway record.

What can AI automate in Greenway Health?

AI fits the repetitive, rules-based revenue cycle work that feeds clean claims inside Greenway Health, the tasks defined well enough to run the same way each time. In the engagements we run, that centers on patient access and payer follow-up:

• Insurance eligibility and benefits. Confirm coverage before the visit through the 270/271 eligibility transaction, or the payer portal where no electronic path exists, and write the result into the Greenway registration record.
• Prior authorization. Submit the request and track its status, which maps to the 278 prior authorization transaction, then record the authorization number in the encounter.
• Claim status. Follow up on submitted claims through the 276/277 claim status transaction so aging is caught early.
• Remittance and denials. Read 835 remittance detail, including the CARC and RARC codes, to route denials for rework rather than reworking them blindly.

Each of these runs on a defined CPT or procedure context, and the agent writes structured results back so the Intergy or Prime Suite record stays complete. To see how this reaches Greenway without an integration, read our overview of AI for Greenway.

Can AI verify eligibility in Greenway (Intergy and Prime Suite)?

Yes. An agent verifies insurance eligibility in Greenway by driving the 270 eligibility inquiry and reading the 271 response, then writing coverage status, plan, copay, and deductible detail back into the registration record in Intergy or Prime Suite. The 270/271 pair is the standard HIPAA transaction for a health plan eligibility benefit inquiry and response, defined by CMS. When a payer supports an electronic 270/271 path, the check is fast and structured; when it does not, the agent works the payer portal or places a call and records the same fields. Running the check before the visit means a benefit is confirmed rather than assumed, which prevents the eligibility-related denials that otherwise surface after the claim is billed. Because Greenway serves both ambulatory Intergy sites and smaller Prime Suite practices, an agent can run the same check across either product. For the mechanism in depth, see insurance eligibility verification.

Can AI handle prior authorization in Greenway?

Yes. An agent handles prior authorization in Greenway by submitting the request, which maps to the 278 prior authorization transaction, and then tracking its status through the payer portal or Greenway worklists until it resolves. It reads the ordered CPT codes and diagnosis from the encounter, assembles the submission, and on approval writes the authorization number and validity dates back so scheduling and billing can see them. When the payer requires clinical documentation the agent cannot supply, or the request pends for review, it routes the case to a person instead of guessing. This keeps the authorization tied to the right encounter in Intergy or Prime Suite and closes the loop before the service is rendered, which is where prior authorization gaps usually turn into denials.

Is it HIPAA compliant?

It can be, and the safeguards are the ones you already apply to any staff member who touches the record. The agent operates under a defined Greenway account with scoped permissions, so it sees and does only what its role requires. Each action it takes is logged, which gives you an audit trail of what was checked in Intergy or Prime Suite, where, and what came back. Protected health information stays inside your systems and the vendor's compliant environment rather than being copied somewhere loosely governed, and the HIPAA-standard transactions such as 270/271 and 278 carry the data in their defined formats. Flexbone is HIPAA compliant and SOC 2 aligned, and the agents are built to gather, record, and hand off, not to make coverage or clinical decisions on their own. Before connecting any agent to Greenway, ask the vendor for its business associate agreement, its access model, and a sample of its audit logs so the controls are verified rather than assumed.

Flexbone can map which of these tasks run cleanly inside the Greenway Health environment your team already uses, across Intergy and Prime Suite, from eligibility and prior authorization to claim status and 835 remittance, and where a voice agent should handle the call around them. To walk through your Greenway workflows and see what AI can run, book a call with Flexbone.