DocStation Copilot is an AI assistant built into the DocStation platform that helps you investigate and resolve claim issues, surface patient eligibility details, query your claims list using plain language, and understand the financial impact of unresolved claims.
🧪 Beta Feature: DocStation Copilot is currently in active beta testing. Features are available to beta participants and are being actively improved based on real-world feedback. Some capabilities may behave differently across payer configurations or claim types. If something does not work as expected, please use the thumbs down feedback button and let us know.
Copilot does not just answer questions from a static knowledge base. When you ask it something, it actively looks up the relevant claim record, reviews the claim history, searches DocStation's internal guidance library, and synthesizes a response before replying. In cases where Copilot cannot take an action, it will tell you directly rather than guessing.
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Accessing Copilot
There are two ways to open Copilot in DocStation.
From a claim tray:
Click Request Support at the bottom of a claim summary. Copilot will open with a pre-filled prompt based on what the claim summary diagnosed, so you do not need to re-describe the issue.
From the Copilot widget:
The Copilot widget is available in the lower left corner of the screen throughout the platform. Click it to open Copilot from any page, including the Claims page, a patient profile, or anywhere else in DocStation.
Note: Copilot is context-aware. When opened from a patient profile, it has access to that patient's data. When opened from the Claims page, it has access to your full claims list and KPI data. When opened via Request Support on a claim, it has access to that claim's record and history.
Using Copilot to Research a Claim Issue
When a claim has an error, an invalid status, or an unexpected denial, Copilot can help you understand what happened and what to do next.
Starting from the Claim Summary
Open a claim and review its claim summary. The summary will describe the issue Copilot has detected.
Click Request Support at the bottom of the claim summary.
Copilot will open with a pre-filled message based on what the summary found. You can send this message as-is or edit it before sending.
Copilot will begin researching the claim. You can watch it work in real time as it pulls the claim record, reviews the claim history, and checks for relevant guidance.
Once Copilot has finished its research, it will respond with a summary of its findings and a recommended next step.
Starting from the Copilot Widget
Open a claim.
Click the Copilot widget in the lower left corner of the screen.
Ask your question in the chat input. You can ask in plain language, for example: "Why was this claim rejected?" or "What do I need to fix on this claim?"
Copilot will run its lookups and respond with findings and recommendations.
Note: Copilot will tell you clearly when it is not able to perform an action from the current context. For example, if you ask it to trigger a new real-time eligibility check from inside the claim tray, it will let you know that action is not available there and point you to where you can run it.
Checking Eligibility with Copilot
From a patient's profile, Copilot can retrieve and summarize existing eligibility check results, including coverage details by service type, Medicare Advantage status, co-pays, co-insurance, and deductibles.
Investigating an Existing Eligibility Check
Open a patient's profile.
Navigate to the Benefits section and click the hyperlink to the patient's eligibility checks.
Open the Copilot widget from the lower left corner of the screen.
Ask Copilot about the patient's coverage. For example: "What does the most recent eligibility check show?" or "Does this patient have Part B coverage?" or "Are they on a Medicare Advantage plan?"
Copilot will retrieve the most recent eligibility check on file and summarize the relevant coverage details.
Note: Copilot can only surface eligibility checks that have already been run and stored in DocStation. To run a new eligibility check with a specific date of service, navigate to the Eligibility section of the patient profile and run the check manually first. Once the check is stored, Copilot can summarize it.
Subscriber ID Lookup
If an eligibility check returns an error due to an incorrect or unknown subscriber ID, DocStation can attempt to verify and return the correct member ID from the payer directly.
Navigate to the Eligibility section of the patient profile.
Enter the subscriber ID on file, or enter a best-guess ID if the correct one is unknown.
Click Check Eligibility.
If the payer is able to locate a corrected ID, the result will display the verified subscriber ID alongside the submitted one.
Note: Subscriber ID lookup is available for payers using API-based eligibility connections. Availability varies by payer.
Querying Claims with Natural Language
The Query with AI feature on the Claims page lets you describe the claims you want to see in plain language instead of building a manual filter.
Navigate to the Claims page.
Click Query with AI in the filter bar.
Type a description of the claims you want to find. For example:
"Show me all my invalid claims"
"Show me rejected claims for Health Partners of Minnesota"
"Show me claims submitted in the last 30 days that are still processing"
Copilot will generate a filter based on your description and display it for review before applying it.
Review the generated filter. If it looks correct, confirm to apply it. If you want to refine it, type a follow-up message.
Tip: Query with AI works well with voice dictation. If your device supports it, you can speak your query rather than typing it.
Note: Query with AI generates filters based on the fields currently available in the claims query builder. If you ask for something that cannot be expressed as a filter, Copilot will let you know and suggest an alternative.
Asking Copilot Questions from the Claims Page
With Copilot open from the Claims page, you can ask it questions about your claims in plain language. There is no set list of questions it expects. If the information exists in your claims data or KPI records, Copilot can generally find it, summarize it, and help you decide what to do next.
Some examples of what you can ask:
"What is the financial impact of my invalid, rejected, and denied claims?"
"How much is at risk from unresolved claims?"
"What are the most common reasons my claims are being denied?"
"Show me claims that are approaching their timely filing window."
"Which payer has the most outstanding rejections this month?"
Copilot will pull from your claims list and KPI data to answer, and you can follow up to go deeper on anything it surfaces.
Example: Analyzing Financial Impact of At-Risk Claims
One of the more powerful things you can do from the Claims page is ask Copilot for a financial summary of your unresolved claims.
Navigate to the Claims page.
Open the Copilot widget from the lower left corner of the screen.
Ask Copilot about your financial exposure. For example: "What is the financial impact of my invalid, rejected, and denied claims?"
Copilot will return a breakdown that includes:
Total amount billed by claim status
Claim count by status
Total at-risk amount across all actionable statuses
You can follow up to drill into a specific status, ask about root causes, or ask Copilot to apply a filter to isolate a particular claim set.
Example: Categorizing Denial and Rejection Reasons
After identifying a set of problematic claims, you can ask Copilot to categorize the denial and rejection reasons across that set.
Apply a filter to the Claims page to isolate the claims you want to analyze, or use Query with AI to generate one.
Ask Copilot to summarize the denial or rejection reasons. For example: "What are the most common reasons these claims were denied?" or "Can you group these rejections by root cause?"
Copilot will review the status reasons across the filtered claim set and return a categorized summary, prioritizing the most common or highest-dollar buckets.
Note: Status reason categorization goes beyond what the query builder currently supports as a filterable field. This is one of the ways Copilot can surface insights that are not yet accessible through manual filtering.
Uploading ERA and EOB Files to Update Claims
🧪 Beta Feature: File upload is an active area of development. The workflow described below is functional but has known limitations with very large files and certain payer-specific export formats. For best results, use targeted per-payer remittance files rather than bulk exports.
If your pharmacy receives Electronic Remittance Advice (ERA) files or paper Explanation of Benefits (EOB) documents that are not yet flowing through an EDI connection, you can upload them directly to Copilot and ask it to update the corresponding claims in DocStation.
Open the Copilot widget from the lower left corner of the screen.
Click the attachment icon in the Copilot chat input.
Select and upload your ERA file or EOB PDF.
Once the file is uploaded, send a message asking Copilot to update the corresponding claims. For example: "Use this ERA file to update the corresponding claims."
Copilot will review the file, identify the claims referenced, and attempt to match them to patient records in DocStation.
Copilot will respond with a summary of what it was able to update, what requires additional review, and any cases where the file data or claim match was unclear.
What Copilot can update from a remittance file:
Claim status
Paid amount
Adjustment reason codes
Patient responsibility amounts (where included in the file)
Important: Copilot cannot guarantee a match for every claim in a remittance file. Always review the summary it returns and verify updated claims before closing out the workflow.
Known limitation: Very large files, such as bulk multi-payer ERA exports or large CSV files, may exceed Copilot's processing capacity in the current beta. Forward Health (Wisconsin Medicaid) files use a format that requires additional work before this workflow is recommended for that payer. Both limitations are being actively addressed.
How Copilot Searches for Guidance
When Copilot is researching a claim issue, it automatically searches DocStation's internal Help Center articles as part of its process. This happens in the background without any action required from you.
If guidance exists in the Help Center for the type of issue Copilot is investigating, it will incorporate that guidance into its response. If no guidance exists yet, that may be an opportunity to document how similar cases get resolved so future instances are handled better.
Copilot can also search the web when a question requires information that lives outside the platform, such as drug coverage policies, prior authorization requirements, or formulary details.
If Copilot determines that a web search would help answer your question, it will prompt you for permission before searching.
Once you approve, Copilot will retrieve and summarize the relevant results.
Copilot will note when information comes from a web search and when plan-specific details may need to be confirmed directly with the payer.
Giving Feedback to Improve Copilot
Every response Copilot gives can be rated with a thumbs up or thumbs down. Feedback is reviewed regularly by the DocStation team and is the primary way Copilot improves over time.
Thumbs up: Confirms that a response was accurate and helpful. This is just as useful as negative feedback and is often skipped.
Thumbs down: Flags a response that was inaccurate, incomplete, or unhelpful. A free-text field will appear so you can describe what was wrong or missing. Even a thumbs down without a note is helpful.
Note: Thumbs down feedback with a written note is the most actionable signal we have during beta. If Copilot gives you an answer that misses the mark, a brief description of what it got wrong helps us identify and fix the pattern.
Frequently Asked Questions
What is the difference between Copilot and the claim summary?
The claim summary is a one-time automated diagnosis that runs when you open a claim. Copilot is an interactive assistant you can have a back-and-forth conversation with. Copilot uses the claim summary as a starting point but can go further, pulling additional data, searching for guidance, and answering follow-up questions.
Can Copilot fix a claim for me?
Copilot cannot directly edit claim fields. It can tell you what to fix, why, and in many cases how, but the actual changes need to be made by you in the claim form. This is expected behavior during beta and may evolve over time.
Can Copilot run a new eligibility check?
Copilot can retrieve and summarize eligibility check results that already exist in DocStation, but it cannot trigger a new real-time eligibility check from inside the Copilot chat. To run a new check, navigate to the Eligibility section of the patient profile.
Why does Copilot sometimes say it cannot help with something?
Copilot is designed to be transparent about its limitations. If it cannot access the information it needs, cannot perform the action you asked for, or is not confident enough in an answer to give one, it will say so directly. This is by design.
Can Copilot see all of my claims?
When opened from the Claims page using the Copilot widget, Copilot has access to your full claims list and associated KPI data. When opened via Request Support on a specific claim, it has access to that claim's record and history. When opened from a patient profile, it has access to that patient's data. It does not have access to data outside of the context it was opened in.
What file types can I upload to Copilot?
Copilot currently supports ERA files (standard EDI 835 format) and EOB documents in PDF format. Other file types are not supported at this time.
What happens if Copilot gives me incorrect information?
Use the thumbs down button and add a note describing what was wrong. This is the most direct path to getting the issue corrected. If you have a time-sensitive claim issue that Copilot has not been able to resolve, reach out to the DocStation Support Team in Chat.
Is Copilot available on all DocStation subscription plans?
DocStation Copilot is currently in beta. Access is being expanded to more customers over time. If you do not see Copilot in your account and would like early access, contact the DocStation Support Team.
Have further questions? Reach out to the DocStation Support Team in Chat!
Join the Beta group and get early access to features here!