Unifying Claims and Care Data into One Seamless Platform.
From pre-authorized virtual and in-person primary care to specialists, procedures, and diagnostics. Manage the full care journey with precision. Design the rules, automate approvals, and monitor every touchpoint in real time.
Trusted by 10,000 + providers, patients and large-scale organisations
From Fragmented Systems to One Unified Flow
- assistant by Medifit connects to your core insurance systems - claims, policy, and CRM - and turns them into a single, structured interface for case handling.
- It pulls relevant case data, policy entitlements, and client history, automatically prefills booking and intake forms, and presents everything in a unified workflow.
- As changes occur, a booking is confirmed, a document is uploaded, or a claim status is updated, assistant by Medifit syncs those events across all systems in real time.
- Agents no longer jump between platforms. Instead, they manage everything from intake to resolution in one place, with every data point connected.
Features That Make Fragmentation
D i s a p p e a r
Unified Case
Interface
All relevant data - claim status, policy rules, contact history, documentation - is shown in one view. No more switching between platforms or copying data across systems.
Smart Data
Prefill
assistant by Medifit fetches structured data from CRM and policy systems to auto-complete claim and booking forms. This speeds up workflows and reduces human error.
Context-Aware
Validation
Built-in rules match policy terms, coverage limits, and claim conditions to validate or flag incoming requests. Low-complexity cases can be handled without agent review.
Auto-Synced Status
Updates
Any change made in assistant by Medifit (bookings, cancellations, claim decisions) is reflected instantly across CRM and claims engines. Everyone works with the same source of truth.
Seamless Document
Management
Files are linked to policyholders, claims, and bookings. Agents and systems always see the right document in the right context without having to dig for it.
Event-Driven
Automation Hooks
Trigger downstream workflows based on what happens in assistant by Medifit: approvals, escalations, no-shows, SLA breaches and customer surveys. Every interaction is logged and ready for reporting or BI dashboards.
Online Booking
Enable agents or customers to book primary care, specialist, diagnostic, or follow-up visits directly. Bookings are made in real time into healthcare providers’ calendars and are fully policy-aware, automatically applying pre-authorization rules, eligibility checks, and benefit limits. This reduces back-office workload and prevents denied claims.
Flexible by Design. Embedded into Your Existing Claims Workflow.
Empower Your Policyholders through a Connected, Branded Digital Experience.
The Patient App by Medifit extends your digital health ecosystem directly to insured members. Through a single, secure interface, policyholders can book appointments, submit claims, access telemedicine, and exchange documentation – all synchronized with your existing claims and policy systems.
The app can be deployed as a standalone, white-labeled solution or integrated modularly into your existing member portal or mobile app. This flexibility allows insurers to enhance engagement and digital service delivery without rebuilding their infrastructure.
- Appointment Booking: book in-network providers directly, policy-aware and pre-authorized
- Claims Submission: submit and track claims digitally, with real-time status updates
- Telemedicine Access: connect with healthcare professionals via secure video consultations
- Document Exchange: upload and access referrals, reports, invoices, and authorizations securely
- Notifications & Reminders: automated updates for bookings, claims, and care plans
Enhance assistant by Medifit with insurer-specific AI features that speed up triage, improve accuracy, and reduce manual workload. All within your existing flow.
Smarter Claims. Powered by
Optional AI Modules
Intelligent Document Classification & Extraction
assistant by Medifit automatically classifies incoming documents (referrals, medical reports, confirmations) and extracts key structured data such as diagnosis codes, service types, patient ID, and referral metadata using AI models trained on healthcare-specific templates.
AI-Powered Decision
Support Engine
Extracted data is processed through an internal decision model that evaluates policy eligibility, coverage rules, and common exclusions. The system flags inconsistencies, detects conflicts, and either resolves or escalates the case.
Confidence Scoring & Workflow Routing
Each case receives a confidence score. High-confidence claims are auto-approved or routed directly to booking. Lower-confidence claims are flagged for review, enabling a human-in-the-loop process without disrupting speed.
Pre-Filled Claim Assessment with Reasoning
For flagged cases, assistant by Medifit prepares a structured decision proposal that includes extracted data, recommended action, and reasoning, reducing the cognitive load for claims handlers.
Event Logging &
Explainability
Every step of the AI-supported process is fully logged. This includes extracted fields, decision outcomes, confidence scores, and booking triggers. All accessible for audit, BI, or regulatory review.
Configurable Automation
Thresholds
Insurers maintain control by setting their own automation limits. assistant only automates when confidence is high and predefined conditions are met otherwise, cases are routed to human review.
Process claims in minutes, not hours.
Reduce claims processing time by 87% while improving accuracy and consistency
Secure by design
assistant by Medifit is built from the ground up to handle sensitive medical and insurance data with integrity, security, and full regulatory alignment. From GDPR and DORA to structured audit trails and role-based access, every action is traceable and protected. No shortcuts — just accountability, end-to-end.
GDPR compliant
Ensures full control over personal data with strict consent management, purpose limitation, transparency, and the right to be forgotten.
DORA compliant
Built for operational resilience with continuous monitoring, incident reporting, secure data handling, and end-to-end traceability.
EU-Based Data Hosting
All sensitive data is stored in secure, GDPR-compliant EU data centers with strict access control and redundancy protocols.