Inferenz Launches AI Agent That Scores Hospice Eligibility and Prioritizes Admissions

Inferenz, a healthcare AI and data solutions company based in Round Rock, Texas, has announced general availability of its Hospice Eligibility AI Agent, a new addition to the company's Caregence agentic AI platform built for healthcare providers.

The agent automates the two workflows at the center of every hospice intake process: referral eligibility screening and admission prioritization.

The problem it targets is familiar to referral intake coordinators. A hospice referral means a patient with weeks left, not years, and admission depends on confirming a physician-certified prognosis of six months or less against face-to-face notes, Palliative Performance Scale scores, and documented decline. A typical 25-person intake team can properly review about 75 referrals a day — some days bring 500.

Reviewers score inconsistently under that pressure, which invites clawback risk and compliance exposure, while slower reviews can cost a provider a qualifying patient who simply gets admitted somewhere that answered first.

The first workflow, automated hospice eligibility screening, pulls the complete referral packet — physician certification, encounter notes, admission forms, and clinical documentation — extracts structured values using Document Intelligence, then applies the provider's own scoring rules, written and edited in plain language by clinical staff, to return an Eligible, Pending Review, or Ineligible determination along with its reasoning.

The second workflow answers a different question: which eligible referrals should get the next open bed. It scores each eligible patient against the organization's own historical admission data, weighing diagnosis fit, referral source, geography, and caregiver availability, to produce a referral-to-admission conversion probability that ranks the queue automatically.

Manual review time drops from 30–90 minutes to about five minutes per referral, and every step is timestamped, giving compliance teams a documented audit trail a CMS reviewer can follow without reconstruction.

"Our Hospice Eligibility Agent doesn't replace clinical judgment. It removes the bottleneck in front of it," said Jalindar Karande, Director-Solutions at Inferenz. The agent joins a broader set of Caregence agents for prior authorization, revenue cycle management, predictive caregiver-to-patient matching, and real-time risk analysis, all built on an interoperable, MCP-based architecture that connects to existing EHR, CRM, or intake portals without requiring a system migration.

Watch next: whether agents like this move from intake automation toward deeper clinical decision support, and how MCP-based healthcare agents scale under value-based care and CMS scrutiny.