AI ARCHITECTURE
Let AI work your denials. Keep sensitive data where it belongs.
Daniel AI works with claim information to help move denial work forward while Red Sky Health controls how sensitive healthcare and financial data is accessed and shared.
See how it worksWHY DANIEL
Some work needs scale. Some work needs judgment.
DANIEL AI
Analyze complex claim context at scale.
HUMAN EXPERTISE
Judgment for true exceptions.
AI carries the volume
People take the exceptions
More denial work can move
Red Sky Health gives AI the scale work and keeps human judgment available for the exceptions that need it.
WHY IT'S BUILT THIS WAY
AI needs enough context to do the work. It does not need unlimited access.
Red Sky Health is designed to give AI the context needed for denial work while limiting how sensitive information moves and where it can go.
ONLY WHAT IS NEEDED · ONLY WHERE IT IS NEEDED
Relevant claim context
Red Sky Health
AI does the work
More work can move without opening every system to every piece of data.
Not every AI needs to see everything.
For certain AI capabilities, Red Sky Health may use an external enterprise AI provider. PHI remains within Red Sky Health before that request is made.
RED SKY HEALTH
Patient information
Claim information
Payer information
Financial information
Daniel AI
Works the denial inside Red Sky Health.
PHI STOPS HERE
Permitted information packet crosses
Result returns to Daniel
OUTSIDE
External enterprise AI
Used only for specific capabilities
No PHI crosses the boundary.
Daniel gets the capability. Your PHI stays behind.
HUMAN OVERSIGHT
Let AI move the work. Keep people where judgment matters.
Red Sky Health analyzes and acts
Does it meet the rules?
YES
Automatically resubmit
EXCEPTION
Human review, when a case needs it
Eligible claims keep moving. Your team steps in when a case genuinely needs them.
Why this matters to your operation.
AI that can act
Clear data boundaries
Exception-based human oversight
More denial work moving
More work gets attention
Eligible accounts no longer wait for limited staff time.
Less routine manual handling
AI works inside the workflow instead of another copy-and-paste tool.
People stay on exceptions
Your team stays focused where expertise matters.
HOW YOUR DATA IS HANDLED
Protected from the moment it enters Red Sky Health.
Your data is encrypted and protected
Sensitive information is protected while it is stored and while it moves through Red Sky Health.
Access is limited
Only the people and systems that need the information can reach it.
Outside AI does not get PHI
When an external enterprise AI capability is used, PHI stays inside Red Sky Health.
Technical architecture
PLAIN-ENGLISH KEY
- Transport
- Information exchanged between key Red Sky Health systems is encrypted.
- Storage
- Claim information sits behind controls that limit how it can be reached.
- Access
- Identity and permissions determine what an authorized user can reach.
- External interfaces
- Outside services connect through defined interfaces, not direct database access.
- External AI boundary
- Where an external AI provider is used, PHI stays inside the Red Sky Health environment.
AI should earn its place in your operation.
Do the work. Use what is needed. Keep sensitive information where it belongs.