EOB Import
Imports explanation-of-benefits data for reconciliation, discrepancy review, and downstream posting support.
Buffaly provides a library of ready-to-use skills designed for healthcare and other regulated industries. From importing revenue-cycle data to navigating clinical ontologies, these tools automate the complex workflows your teams handle every day.
Additionally, Buffaly can often use the tools you already have. There is no need to write complex MCP servers or build custom adapters to make your infrastructure agent-safe. It connects natively to your existing systems, APIs, and databases.
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Start here when the job is tied to billing, reimbursement, payment intake, remittance data, or eligibility checks that need to happen before claims move forward.
Imports explanation-of-benefits data for reconciliation, discrepancy review, and downstream posting support.
Imports electronic remittance advice including standard 835-style remittance files for payment and adjustment workflows.
Imports claims from the EMRs we work with so claim rows can be normalized, attached, reviewed, and followed through the revenue cycle.
Pushes or synchronizes claims into Tebra/Kareo-oriented billing workflows where that downstream system is the target surface.
Checks insurance eligibility, verifies benefit context, and routes exceptions before downstream revenue work begins.
Reconciles payer payments, patient payments, and adjustments across imported payment sources and billing records.
These skills ground downstream workflows in diagnosis, procedure, and terminology semantics so automation can operate with real clinical meaning instead of string matching alone.
Supports clinical terminology mapping, normalization, concept lookup, and ontology-aware reasoning using SNOMED CT.* You may need to provide your own license before using this ontology in production, as it can be restricted.
Supports diagnosis-code normalization, coding support, crosswalk workflows, and diagnosis-aware automation using ICD-10 data.* You may need to provide your own license before using this ontology in production, as it can be restricted.
Supports procedure-code lookup, billing-code validation, code grouping, and workflow logic that depends on CPT terminology.* You may need to provide your own license before using this ontology in production, as it can be restricted.
These skills support intake, chronic-condition review, and determination of which ongoing care programs a patient should be routed into next.
Evaluates whether a patient appears to have chronic conditions that qualify them for specific care-management or monitoring programs.
Normalizes new patient demographics, payer data, contact details, and enrollment-ready fields at the start of the workflow.
Determines whether a patient belongs in a remote-care workflow and what operational path should be triggered next.
Supports Advanced Primary Care Management workflows, including enrollment, tracking, and compliance-oriented operations.
Supports Remote Therapeutic Monitoring workflows for therapy-related monitoring, documentation, and downstream operations.
Supports Chronic Care Management qualification, workflow routing, and longitudinal operational follow-up.
Supports Remote Patient Monitoring qualification, monitoring intake, review queues, and ongoing exception handling.
These skills support the teams actually running the work: care-program execution, queue management, outreach, intake coordination, and FairPath-driven operational workflows.
Supports FairPath operational workflows including imports, eligibility, remote-care execution, and workflow routing for teams running healthcare operations.
Supports lead-agent, operational intake, and workflow orchestration with a mix of DLL-backed and prompt-backed actions.
Represents the operational workflows behind RPM, CCM, RTM, APCM, and associated queues, escalations, and follow-up work.
Supports outreach-oriented operational tasks including patient follow-up, reminders, and messaging coordination.
Handles the queueing, routing, and coordination work that turns incoming demand into actionable operational tasks.
Connects eligibility checks, intake reviews, and exception routing into the broader operations workflow.
Each EMR or PM system can have several separate skills underneath it: imports, exports, payments, eligibility workflows, reconciliation paths, and UI automation fallbacks.
Multiple skills under ECW: demographics import, claims import, claim status updates, payments import, and operational browser workflows when needed.
Multiple skills under Tebra/Kareo: claims import, payments import, export reconciliation, scheduling/intake handoffs, and future claim-push workflows.
Multiple skills under Athena: payment import, EOB parsing, claims workflows, and future demographic automation paths.
Multiple skills under InSync: claims import, payments import, staging analysis, and operational routing for discrepancies or follow-up.
Multiple payer-surface skills: browser-based portal entry, benefits verification, remittance lookup, EOB/ERA retrieval, and exception review.
Model providers should be visible as their own execution layer. These skills represent provider-specific surfaces like Codex, Gemini, Grok/X, OpenAI, and cross-model orchestration.
Supports code editing, structured implementation work, and development-agent workflows through Codex-backed execution.
Represents Gemini-backed reasoning, generation, and model-specific workflow execution where Gemini is the chosen LLM surface.
Represents Grok-oriented or X-adjacent large-model execution surfaces where that model family is the target capability.
Represents general OpenAI-backed model capabilities beyond specialized browser or desktop automation layers.
Coordinates model selection, prompt-routing, and workflow decisions across multiple LLM surfaces instead of coupling everything to one provider.
These are the lower-layer skills that let Buffaly operate environments, inspect data, manage files and repositories, and integrate with the systems beneath the workflow surface.
Handles Gmail, Drive, Docs, Sheets, and Calendar workflows when collaboration and document automation are part of the operating model.
Supports address normalization, geolocation lookup, place resolution, and map-context enrichment when provider, practice, or patient records need real-world location context.
Supports NPI Registry lookup, provider identity verification, taxonomy and credential resolution, and matching healthcare records to authoritative provider context.
Supports SQL Server discovery, querying, and database-adjacent operational work for systems where the data surface matters directly.
Provides local workspace inspection, file search, read, and open capabilities used by many higher-level workflows.
Handles repository operations, git workflows, and GitHub organization tasks that support code and automation delivery.
Supports AWS infrastructure tasks such as Route53, ALB, network diagnostics, and storage-oriented discovery workflows.
Provides session organization, maintenance, and continuity support across Buffaly operational work.
When an EMR, payer portal, or back-office system is best handled through the UI, Buffaly can still automate the work through browser and desktop/computer-use skills.
Navigates websites, interacts with pages, captures snapshots, and verifies browser state for EMRs, portals, and operational web workflows.
Handles broader computer-action workflows when browser-level automation needs a desktop-style fallback.
Automates mouse, keyboard, wait, and screenshot operations for local or remote desktop workflow steps.
Buffaly can extend itself. If the workflow or capability you need is not listed here yet, Buffaly can add new skills around your environment and operating model.
Buffaly works with your existing code and APIs natively, so you can bring in the tools you already trust without rewriting them into a new abstraction.
No special adapters needed. Buffaly can operate directly against native code, local services, and existing system interfaces without forcing an MCP layer in between.