Intake Agent · live MME Compliance · monitoring EOB Recon · processing Claim Intel · 2,841 active
AI agents for the business of healthcare

The agent layer for injury and pain care coordination.

We build custom AI agents that run intake, billing, charge audits, MME compliance, claim intelligence, and HIPAA-compliant communication — across the lawyer, provider, and pharmacy stack.

A–Z
Case lifecycle
24/7
Trigger-based alerts
HIPAA
Compliant messaging
100%
Custom-built agents
Personal Injury Workers' Compensation Motor Vehicle Accident Pain Care Coordination Pharmacy Reconciliation Lien-Based Billing EOB Intelligence MME Compliance Personal Injury Workers' Compensation Motor Vehicle Accident Pain Care Coordination Pharmacy Reconciliation Lien-Based Billing EOB Intelligence MME Compliance
Built for three audiences

One platform. Three sides of the case.

Lawyers need coordination. Providers need workflow that lives above their EHR. Pharmacies need clean billing and reconciliation. Maximal Labs ships AI agents purpose-built for each.

For Lawyers

End-to-end care coordination for PI, WC, and MVA cases. Track every encounter, lien, document, and provider interaction from sign-up to settlement.

For Providers

An AI workflow layer that sits above your EHR. Chart-note summarization, intake automation, charge audits, scheduling, and patient-experience agents.

For Pharmacies

EOB-aware billing and reconciliation agents, controlled-substance compliance, MME monitoring, and trigger-based alerting on every claim, refill, and remit.

See it in action

The Document Management AI Agent.

Watch the agent ingest medical records, bills, lien letters, and EOBs — classify them, extract structured data, and route every artifact to the right place in the case file.

maximallabs.com / agents / document-management
Inbound
medical_record_4421.pdf
eob_aetna_q3.pdf
lien_letter_smith.pdf
chart_note_2026.pdf
itemized_bill.pdf
AGENT
Document Management
Type EOB · Aetna
Patient Smith, R.
Charges $4,218.00
Routed to Case #PI-22041
The agent stack

Custom agents for every workflow.

Off-the-shelf RPA breaks the moment a fee schedule updates. Our agents reason, research, and adapt — and we build them around your exact case lifecycle.

Intake

Intake Agent

Captures referrals from any source — fax, portal, email, phone — and stands up a complete case in seconds with verified demographics and injury details.

Revenue

Charge Audit Agent

Scans every charge against the latest payer fee schedules and CPT modifier rules. Flags under-coding, duplicates, and missed line items before submission.

Reconciliation

EOB Reconciliation

Reads every EOB line, matches it to the originating claim, and writes back posting, adjustments, and denial reasons — no human re-keying.

Intelligence

Claim Intelligence

Predicts denials before submission, surfaces aging risk, and recommends the highest-yield next action on every open claim in the pipeline.

Compliance

MME Compliance Agent

Continuously monitors morphine milligram equivalents across every patient. Alerts before thresholds are crossed, with a full audit trail of decisions.

Alerting

Trigger-Based Alerts

Configurable rules engine that routes the right alert — over MME, missed appt, lien hot, denial received — to attorney, provider, or pharmacy in real time.

0%
Of repetitive work automated
0
Avg. time to first agent live
0
Pre-built agent types
0%
HIPAA-compliant by design
Estimate your impact

What could AI agents save your operation?

Three sliders, transparent math. Drag to match your monthly volume — see annual savings update in real time.

Cases or claims per month 800
Avg. billed amount per case $2,500
Operations team size today 8
Estimated annual ROI
$0
Labor savings + revenue uplift, based on industry-average benchmarks.
Hours saved / yr
0 hrs
Revenue uplift / yr
$0
~8 min saved per case · 2.5% charge audit uplift · $42/hr loaded labor
Why Maximal

Not another offshore RCM team. An AI agent platform.

Most healthcare ops still run on people, spreadsheets, and screen-share tools. We replace the repetitive 80% with reasoning agents — and let your team focus on the work that requires judgment.

  • 01
    Built around your case, not a SaaS template Every agent is configured to your fee schedules, payer mix, lien workflow, and intake sources.
  • 02
    HIPAA-first by design Encrypted at rest and in transit. Auditable agent decisions. PHI handling that survives a payer audit.
  • 03
    Continuous research agents Fee schedules, CMS rules, and state requirements change constantly. Our research agents keep your billing logic current — automatically.

Legacy offshore RCM

  • People doing repetitive data entry
  • Static playbooks, slow to update
  • Email and Slack for case updates
  • Errors only caught at month-end
  • Compliance is a quarterly review

Maximal Labs AI

  • AI agents handling 80% of repetition
  • Self-updating fee schedules and rules
  • Real-time HIPAA-compliant messaging
  • Errors caught before submission
  • Compliance is continuous and audited
Frequently asked

Questions ops teams ask us first.

How fast can we get an agent live?
Most clients have their first agent in production within 4–6 weeks. We start with one workflow that's high-pain and high-volume — usually charge audit, EOB reconciliation, or document management — so you see ROI before scope expands.
Is the platform HIPAA-compliant?
Yes. All data is encrypted at rest and in transit, every agent decision is logged for audit, and we sign a BAA with every customer before any PHI moves through the system. Compliance is continuous — not a quarterly review.
Does it integrate with our EHR or pharmacy system?
Yes. We sit alongside your existing systems — Epic, Athena, Pioneer Rx, Liberty, and others — via API, HL7, FHIR, or RPA where APIs aren't available. No rip-and-replace, no system migration required.
What does pricing look like?
Per-agent licensing, scaled by volume. We share a custom proposal after a 30-minute scoping call so the price reflects the actual workflow we're solving — not a generic SaaS tier. Most clients see payback inside 90 days.
Will agents replace my team?
No. Agents replace the repetitive 80% — data entry, document classification, status checks, alert routing — so your team can focus on the work that requires judgment. Most clients re-deploy people to higher-value functions, not lay them off.
Is our data shared between clients?
Never. Every client runs in a dedicated tenant with isolated storage and inference. Your case data, fee schedules, and configurations stay yours — and stay separated from every other customer.
Can you build custom agents for our workflow?
That's our specialty. The catalog on our solutions page is a starting point — most clients also commission one or two custom agents within the first quarter. Bring us the workflow; we'll scope and build.
Ready when you are

Let's automate the boring 80%
of your case workflow.

Tell us about a workflow that's stuck on people and paper. We'll show you the agent that fixes it — usually within a 30-minute working demo.