Unlimited agents. One system. Your EHR and every system around it.
The same infrastructure runs Shift’s core prebuilt agents, and any agent your own team builds on top of it.
Shift’s Agent OS ships with a library of prebuilt agents, workflows, skills, and tools, each one built for a specific job in the revenue cycle and patient journey. They aren’t separate tools you buy and stitch together, they share the same coverage data, the same payer rules, the same audit trail, and the same patient record, so the work one agent does makes every other agent better. A coverage check feeds a coding decision, which feeds a resubmission decision, which feeds a collection estimate, all from one verified source, not four separate lookups.
Architecture
Full access, not just what an API allows
Shift Agents connect through a real API wherever one exists, paired with Shift’s own Browser Agents wherever it doesn’t, the same kind of technology behind tools like Computer Use, navigating an EHR’s actual screens for direct access to patient charts, the clearinghouse, and schedules. That combination, API plus Browser Agent, is what gets to full read and write access, not the partial, often read-only slice most EHR APIs expose on their own. Every tool call uses the same atomic contract no matter which connection method is underneath, an agent doesn’t know or care whether a result came back from an API response or a Browser Agent session. Add a new system, add a connection, the agents themselves don’t change.
Reads run free, writes are gated
Every tool is atomic and verb-level: reads (pull a schedule, check eligibility, read a note) execute without restriction, writes (post a code, submit a claim, update a record) are confidence-scored, gated by the autonomy tier you’ve set, and read back after every write to confirm it actually posted, not just that the request was sent.
Knowledge bases match how the data actually behaves
Structured lookups for exact-key data (CPT codes, fee schedules, payer IDs), embeddings for prose that needs semantic retrieval (payer coverage policy, customer SOPs), and hybrid KBs where both apply (a 271 response that’s part structured field, part inconsistent free text). Each agent’s knowledge bases are matched to the shape of what they’re actually looking up, not a single one-size-fits-all vector store.
Orchestrators delegate to sub-agents
Each prebuilt agent is itself an orchestrator that calls specialized sub-agents for the pieces of its job, a coding engine, a compliance check, a confidence scorer, for example, so the reasoning for a complex task is broken into pieces that can be tested, audited, and improved independently.
Channels — build once, deploy anywhere
Every channel runs through the same atomic tool contract as everything else on this platform, an agent doesn’t behave differently because a conversation came in over text instead of a phone call. Identity is verified before anything sensitive is shared, and the system picks the right channel for the job.
See how channels work →Shared capabilities
Built once, every agent that needs it benefits — the actual stickiness and compounding-value story, not a slogan:
Payer/Plan Rules KB
One shared source for auth-required, referral-required, and COB/Medicaid-secondary rules per payer and plan, read by every agent that needs to know before, during, or after a claim goes out. Consolidated once instead of maintained separately per task.
Coding Engine
The same coding logic that assigns codes on the front end is the same sub-agent used for coding-related corrections on the back end.
Billing Q&A
The same logic that answers a patient’s balance question live is used for outbound collection outreach.
Payments
One payment-collection capability, used at point-of-service and in live billing resolution.
Responsibility Estimator
Shared between the pre-visit copay estimate and the post-visit ledger lookup, the same underlying calculation, two different moments in the patient’s journey.
Control and trust
Tier 1
Assist
Agent surfaces, human applies.
Tier 2
Supervised
Agent acts, human reviews everything.
Tier 3
Exception-based
Agent acts on high confidence, routes the rest — the recommended tier for most practices.
Tier 4
Full Autonomous
Agent acts on nearly everything, human spot-checks a dashboard.
Start wherever you’re comfortable. Raise the tier per agent, per task, as the accuracy proves out on your own claims, not in the abstract. Every write is confidence-scored and logged. Full audit trail, per-action rationale, 7-year retention, nothing happens off the record.
Security & compliance →Works with your stack
Shift Agents connect through Tools, built for whatever your practice actually runs, your EHR, your documents, your payers, your payment systems. No rip-and-replace.
See how it connects →Shift Agent OS
The same Agent OS our agents run on, yours to build with.
For teams that want to own building, testing, and managing their own agents and workflows, on the same platform, with the same guardrails.
Not the primary sell — this section exists for the enterprise buyer who’s already looking for it (a health system or larger group with its own technical team), not the 40–75-provider ICP the rest of the site speaks to.
Console Agent
Build, test, and update agents and agentic workflows in plain English.
Learn more →Helper Agent
Ask any question about what your agents and workflows are actually doing, in plain English, across every location.
Learn more →Channels
Build once, deploy everywhere your patients and staff already are.
Learn more →Security & Compliance
Enterprise-grade security and governance across the platform.
Learn more →Configure
The primitives underneath all four:
Agents
The agents themselves, built and run on the same orchestrator architecture.
Workflows
Agentic workflows, multi-step processes composed from an agent’s own tools and skills, exposed and callable the same way a single tool is.
Skills
Reusable capabilities an agent calls on (documentation retrieval, confidence scoring, and more); extend Shift’s library or build your own.
Knowledge Base
Connect and manage retrieval, structured lookups, embeddings, or hybrid, matched to how your own data actually behaves.
Tools
Atomic, auditable read/write actions bound to your systems; reads run free, writes are gated and read-back verified, by default.
Guidelines
The guardrails and autonomy tiers that govern what an agent may do without review, configurable per agent, per task.