GenHealth.ai Launches AI-Powered Order Automation Solution

BOSTON, Massachusetts—GenHealth.ai announced the launch of its artificial intelligence (AI)-powered automation solution specially designed for durable medical equipment (DME) and home medical equipment (HME) providers, helping relieve the burden of complex workflows such as medical order intake, eligibility verification and prior authorizations. This launch marks an expansion of GenHealth.ai’s mission to bring intelligent, scalable automation to health care operations-boosting accuracy, reducing delays and accelerating access to care, said GenHealth.ai.

Developed in partnership with early DME customers, GenHealth.ai’s platform streamlines the medical order lifecycle using new advancements in AI and large language models (LMMs)—combined with deep integrations into existing EMR and billing systems—specifically for DME and HME providers.

Key capabilities include:

• Automated Patient Intake: Consolidates all incoming orders-fax, email, EHR and portals-into a single inbox. Processes even handwritten forms and fills in data to billing systems and electronic medical records
• Real-Time Coverage & Eligibility Checks: Verifies insurance coverage through clearinghouses or direct payer integrations, extracting key plan-level details like deductible status, coverage limits and co-pays
• Medical Necessity & Prior Authorization Submission: Compares clinical documentation-such as physician notes-against payer policy requirements, identifying gaps in real time, ensuring every order is audit-ready before it hits the billing queue
• Seamless Billing Integration: Pushes claim-ready orders directly into systems like Brightree and NikoHealth, eliminating rekeying and toggling between platforms
• Deep Insight into Payment Analytics: Compare reimbursement rates against historical benchmarks and peer performance metrics using GenHealth’s Large Medical Model (LMM)
• Early Results: Less manual work and higher Accuracy

Across early implementations, GenHealth.ai has delivered:

• Four times increase in orders processed per employee
• Fifty percent reduction in manual review time
• More than 95% alignment with human utilization management (UM) decisions

“With AI, customers are able to bring on our AI agent to help their existing teams process more cases and increase revenue while reducing administrative costs.” said Ethan Siegel, CPO. 

“DME providers deserve tools that reduce friction across every step of the order process—and they shouldn’t have to rip out their systems to make it work,” said Ricky Sahu, CEO. “Our AI integrates into existing customer apps without disrupting how their teams work today.”

Expanding the Vision for Smarter Healthcare Operations

In addition to the DME solution, GenHealth.ai has developed a prior authorization automation solution for providers, designed to accelerate access to high-cost therapies such as GLP-1s and chemotherapies. By combining AI, patient charts and payer-specific coverage logic, the platform helps providers achieve faster patient-centered approvals-resulting in higher approval rates.

GenHealth.ai will be showcasing these capabilities live at the VGM Heartland Conference in Waterloo, Iowa, on June 10-11, 2025 and at ENDO 2025 in San Francisco, California, on July 12-14, 2025.