Healthcare Operations

Your system cares for the patient.
CaseFy orchestrates the operation.

From beneficiary enrollment to provider credentialing, from prior authorization to claim disputes — orchestrate every healthcare process with regulatory deadlines, traceability and AI agents.

Free for up to 3 users. No credit card required.

The healthcare system stops here.

After medical records and billing, your operations enter no man's land.

What the system does well

Electronic health records (EHR)
TISS/TUSS billing
Appointment scheduling
Bed management

What the system does NOT do

Orchestrate beneficiary enrollment with docs and waiting periods
Provider credentialing with site visits and approvals
Prior authorization with regulatory deadlines and multiple reviews
Claim disputes with evidence and decision chains
Portal for providers/beneficiaries to track their process
AI that pre-analyzes requests and monitors deadlines

In healthcare operations, the system handles data. The processes that keep the machine running live in email, WhatsApp and spreadsheets.

Sound familiar?

Provider credentialing has been stalled for 3 months and they've already given up.

Network Manager

We have $400K in pending claim disputes and don't know which ones to contest in time.

Claims Manager

Authorization deadlines expire because the medical review is delayed.

Authorization Analyst

The regulator asked for traceability and it took us 3 weeks to compile.

Compliance
The solution

Every process becomes a case.

A case is the complete lifecycle of the operation — with documents, approvals, regulatory deadlines, external participants and AI agents.

Request
Analysis
Review
Decision
Communication
Completed
Sistema de saúde
CaseFy

Everything the healthcare system lacks. Everything you need.

Automatic regulatory deadlines

SLA by procedure type. Escalating alerts: yellow → red → critical.

Documents + Versions

Licenses, credentials, reports, TISS forms — all linked to the case.

Formal decisions

Medical review with justification, identified reviewer and timestamp. Full audit trail.

Provider portal

The provider tracks credentialing without calling 5 times.

AI Agents

Doc Reviewer validates documents. Deadline Guard monitors deadlines 24/7. Summarizer generates reports.

90+ permissions (HIPAA/LGPD)

Granular access control. Sensitive health data protected by design.

Immutable timeline

Who decided, when, with what justification. Compliance proof for regulators.

Automations

Docs complete? Move to analysis. Deadline at risk? Escalate to director.

4 steps to orchestrate healthcare operations

01

Create your healthcare template

Define stages, documents, regulatory deadlines and automations.

02

Open a case for each process

Each enrollment, credentialing or authorization becomes a traceable case.

03

Involve providers and beneficiaries

External portal to track, submit documents and receive decisions.

04

Let AI work

Agents validate documents, monitor regulatory deadlines and generate reports automatically.

Ready-made templates

7 templates for healthcare operations

Beneficiary Enrollment

8 stages

From proposal to activation. Documents, waiting periods, contract and welcome kit.

Provider Credentialing

9 stages

Document analysis, site visit, review, negotiation and contract. From 6 months to 30 days.

Prior Authorization

7 stages

Request, technical analysis, medical review, decision. Automatic regulatory deadlines.

Claim Dispute

8 stages

Identification, evidence, feasibility, contestation. Stop losing money.

Medical Audit

8 stages

Sampling, record analysis, discrepancies, review and action. Fully traceable.

Hospital Accreditation

9 stages

ONA/JCI: self-assessment, action plan, internal and external audit. 12-24 months orchestrated.

Numbers that matter

30 days
Credentialing
vs 4-6 months current
99%+
Regulatory deadlines met
vs ~85% current
95%+
Claims contested on time
vs ~60% current
Minutes
To gather audit evidence
vs 2-4 weeks current

CaseFy vs. Traditional healthcare system

Operational need
Healthcare system
CaseFy
Orchestrate multi-step enrollment
N/A
Cases + Stages + Tasks
Collect provider documents
Email + WhatsApp
Portal + Forms + Documents
Formal medical review
Email + stamp
Decisions + Review Requests
Deadline alerts
Spreadsheet / memory
Automatic SLA + AI Agent
Provider tracks process
Call us
External portal + Chat
AI that pre-analyzes requests
Manual
Native AI Agents
Audit trail for regulators
N/A
Immutable timeline
Data confidentiality (HIPAA)
Limited
90+ granular permissions
Compliance & Regulation

Built for the most regulated industry

Regulatory Deadlines

Automatic SLA by procedure type with 24/7 AI agent monitoring.

HIPAA/LGPD

90+ permissions, encryption, audit trail. Sensitive health data protected.

TISS Standards

Configurable fields mapped to TISS. Timeline proves compliance.

ONA/JCI

Each accreditation requirement is a case with linked evidence and deadline.

Medical Board

Formal medical reviews with justification, identified reviewer and timestamp.

Health Authority

Credentialing cases with linked documents and monitored validity.

Complementary, not a replacement

Use with your healthcare system. Not against it.

CaseFy doesn't replace your EHR or hospital system. CaseFy orchestrates the operational processes those systems don't cover.

Epic
Cerner
MEDITECH
Allscripts
athenahealth

Integration via webhooks + Zapier/Make. Native integrations coming soon.

Healthcare operations need more than a clinical system.

Start free with the Prior Authorization template. No credit card, no migration.

Free for up to 3 users. Templates ready to use.