Healthcare automation solutions development

Edenlab builds large-scale healthcare systems for complex workflows such as CDSS, eRx, appointment management, RCM, and EHR, and complements them with agentic or robotic process automation (RPA) layers that operate across systems and take over repetitive, high-volume tasks.

Expertise you can trust

Strong data management focus

Automation in the healthcare industry is effective when data is standardized and reliable. Unstructured inputs, or workflows that depend on individual judgment, don’t fit automation well. Our core strength lies in data management and preparation. We ensure that automation runs on trustworthy, consistent information.

AI experience, applied pragmatically

We apply RPA and AI in healthcare where they deliver measurable speed and accuracy in data extraction, routing, and decision support. We build systems where specialized AI agents can call APIs, collaborate with other agents, and operate across multiple healthcare systems, orchestrating end-to-end workflows rather than isolated tasks.

Nationwide healthcare system extensions with automation modules

We have hands-on experience evolving large-scale national HIE and healthcare clearinghouse ecosystems, complemented by automation modules for CDSS, eligibility checks, prior authorization, claims processing, and payment reconciliation.

Two ways we deliver healthcare automation services

Building specialized automation software platforms

We create standalone, scalable products and platforms that automate end-to-end workflows, or add custom process automation modules to existing systems.

Adding an automation layer on top of your existing systems

We close routine and “not smart enough” gaps inside your current stack using agentic middleware and RPA for healthcare across EHRs, payer portals, back-office tools, and more.

For example, an agent can automatically collect missing clinical data from the EHR, submit a prior authorization request in the payer portal, track its status, and route exceptions to staff only when human review is required.

Case study

Payers & TPAa

Hong Kong

Heals.Asia: Building an automated claim processing engine

We built an FHIR facade that automates provider directory access and real-time specialty/location search, and added an auto-adjudication engine to streamline claim intake, preauthorization, edits, and routing for faster turnaround.

Case study

Governmental agency

Building a healthcare financial message exchange hub

Developed a national clearinghouse that digitizes connectivity between providers and payers. Supports FHIR-based workflows for eligibility checks, prior authorization, claim clearing, and payment reconciliation.

How we implement automation on top of your current systems

RPA in healthcare with a configurable BPM layer

For routine, rule-based work, we utilize our BPM-style software to design automation scenarios directly within the interface, eliminating the need to rebuild your EHR, billing, or payer integrations. It works well for automation tasks like patient visits and route planning, inventory management, partner relation management, and document management.

Custom AI agent-driven software for complex, high-volume workflows

When the process requires context and flexible decision-making, we incorporate agentic automation. Our custom-built assistants can interpret intent, gather the right data from connected systems, trigger the next action, and escalate exceptions to humans with full context. It’s a practical fit for workflows such as clinical decision support, eligibility checks, and any multi-step smart coordination across various tools.

Conversational interoperability

We enable systems and AI agents to coordinate through structured conversations rather than fixed integrations. For example, one agent can negotiate prior authorization requirements with a payer system, or collaborate with EHR agents to perform clinical trial matching across multiple data sources.

Learn more about our interoperability expertise

We deliver automation at any level of complexity

Automation of tasks traditionally performed by humans

This layer helps to replace manual steps. It works best when the process is clear, repeatable, and driven by structured data. Robotic process automation in healthcare can reside within a single system (such as an EHR) or orchestrate steps across multiple systems.

Automated data entry

Convert paper-based, scanned documents into structured digital data.

Eligibility checks

Run verifications, store the results, and automatically trigger the next step.

Prior auth intake

Submit requests, poll status, and route updates to queues.

Claims follow-up

Pull payer responses, categorize outcomes, and create tasks for exceptions.

Payment posting and reconciliation

Match payments to claims, flag mismatches for review.

Data management orchestration

Run multi-stage ELT workflows across existing data tools and platforms.

Let’s discover your automation opportunities together

These examples represent only a small subset of possible healthcare automation solutions. We’ll help you identify and prioritize workflows where automation creates measurable business impact.

Intelligent process automation in healthcare with humans in the loop

This is where the workflow becomes “better than manual,” yet still remains under human control. We created a product – Kodjin – that provides an AI layer on top of consolidated, structured healthcare data, so automation becomes a system capability. Under the hood, this relies on:

a semantic layer with consistent definitions,
temporal reasoning to understand clinical sequences,
privacy-preserving architecture to protect patient data.

Examples of what we can build for you with the Kodjin AI layer

Clinical documentation flow automation

The AI guides the process based on clinical sequences. Manages documentation across a clinical episode by understanding the timeline, spotting missing elements.

Patient care gap closure as a managed process

The AI assesses relevance, prioritizes patients, recommends next-best actions, and adapts outreach to comorbidities and recent events.

High-risk patient monitoring workflows

The AI helps determine when to escalate, who should take action, what justification to include, and which actions are sensible at this time, while maintaining temporal context.

Utilization and treatment pathway optimization

The AI detects pathway deviations, explains likely drivers, proposes adjustments, and supports decision documentation.

Multidisciplinary care coordination

Coordinates work across roles and systems by understanding responsibilities and process stages, detecting handoff breakdowns, and proposing the next action.

Request a demo

Automation paths we offer, depending on your company's goal

Robotic process automation in the healthcare ecosystem can solve very different problems. Some businesses seek rapid cost reduction within existing operations. Others want to upgrade the service itself and compete based on experience and data value. Edenlab supports both paths, and the same data foundation can power them together.

Reduce costs by streamlining operations

Utilize automation to eliminate manual steps and expedite internal workflows. No-code and low-code tools enable staff to automate routine tasks across a single system or multiple systems, including data entry, scheduling workflows, RCM, document routing. The result is lower admin load, fewer errors, and faster turnaround without changing your core service model.

Create new value through digital-first RPA services for healthcare

Utilize automation to enhance the experience for patients and partners. This approach adds product-level software for both staff and patients. For example, instead of manually sending procedure results as PDFs, you deliver digitized documents in a patient portal, enabling trends, follow-ups, and analytics that make your service more competitive.

Automation opportunities we provide across different business types

Payers & TPAs

Member onboarding and eligibility workflows
Plan and benefit configuration automation
Prior authorization workflows and status tracking
Compliance and regulatory reporting pipelines
Claims intake, edits, and exception routing
Utilization management automation
Cost and performance tracking

Providers

Scheduling, intake, and capacity workflows
Patient alerts, reminders, and follow-up sequences
Resource utilization and operational coordination
Claims processing and denial work queues
RCM automation across billing, collections, and reconciliations
Inventory and supply workflow automation
Clinical documentation improvement support

Healthcare IT vendors

Integration orchestration across partner ecosystems
Agentic data management orchestration
Agentic workflows embedded into end-user products
Engagement assistants and self-service bots
Automated testing, monitoring, and release checks
Implementation accelerators and deployment tooling
AI-supported product roadmap planning

Why choose Edenlab as your healthcare automation partner?

With the help of healthcare RPA services, Edenlab helps organizations automate complex workflows without losing control, compliance, or data quality. We combine platform engineering, healthcare domain expertise, and AI-ready data foundations to deliver automation that scales and continues to function effectively as rules and systems evolve.

Trusted expertise

Our team combines in-depth healthcare knowledge with strong engineering expertise. We understand real-world workflows across payers, providers, and national ecosystems, ensuring that automation aligns with clinical and financial realities.

Lean development, maximum impact

We build in focused teams and ship in measurable steps. You get clear documentation, predictable delivery, and automation that’s designed to evolve: new rules, new integrations, and new volumes without constant rebuilds.

Proven at the national scale

We’ve delivered and enhanced high-load, interoperability-driven platforms, including large HL7 FHIR programs serving tens of millions of users. That experience directly translates to automation modules, such as eligibility checks, prior authorization, claims, and reconciliations.

More about our approach