Agentic operating systems for healthcare workflows
Tactical Edge builds governed AI agents that coordinate prior authorization, care management, care-gap closure, discharge follow-up, and member engagement while preserving clinical ownership.
Where we start
We begin with workflows where evidence is spread across systems, rules are inspectable, and human review can be preserved at the right threshold.
Prior Authorization Intake
Agents gather evidence, match criteria, detect missing documentation, and prepare review-ready packets.
Care-Gap Closure
Agents identify eligible members, prepare outreach, track completion, and route exceptions to care teams.
Discharge Follow-Up
Agents reconcile discharge notes, coordinate next steps, and flag high-risk transitions for clinical review.
Appeals Preparation
Agents assemble denial reasons, medical evidence, timelines, and policy references for accountable review.
Workflow model
Controls built in
Every agent action is bound by data access, consent, tool permissions, policy version, evaluation score, and audit evidence. High-risk decisions route to accountable humans.
Clinical teams stay central
Agents prepare, route, and monitor work. Clinicians and operations leaders own judgment, exception handling, program design, and final approvals where risk demands it.
Implementation path
Workflow discovery and risk classification
FHIR, claims, document, and care platform integration
Agent design for evidence, policy, risk, outreach, and routing
Human review console and operating metrics
Evaluation harness, audit logs, and production monitoring
Move healthcare work from queues to outcomes
We can help define the first workflow, design the agent control plane, and take the system through evaluation, shadow mode, and monitored production.