Automate medical claims processing with GPT-4 multi-agent orchestration
Ready for 3.0Ready for 3.0. This template uses no nodes that n8n 3.0 removes. No removed nodes, versions or helpers found. Static check, last run 2026-10-19.
What this workflow does
This AI workflow has 27 nodes and runs on a schedule (every day at 02:00). Along the way it connects OpenAI Chat Model.
How it runs
Trigger: On a schedule (every day at 02:00).
- Workflow Configuration (Edit Fields (Set)): sets 4 fields: revenueSpecialistEmail, complianceThreshold, highRiskThreshold…
- Simulate EHR/Billing Data (Code): runs custom JavaScript code
- Orchestrator Agent (AI Agent): runs an AI agent, with model: OpenAI Model - Orchestrator; 4 tools (Payer Follow-up Agent Tool, Denial Detection Agent Tool, Claims Submission Agent Tool, Coding Validation Agent Tool); output parser: Orchestrator Output Parser
- Route by Risk Level (Switch): routes items into 3 branches
- Check Compliance Flags (If): checks a condition and branches into true / false
- Store Claims Records (Data table): uses Data table
- Store Denial Records (Data table): uses Data table
- Escalate to Revenue Specialist (Send Email): sends an email over SMTP
- Store Audit Trail (Data table): uses Data table
- Merge: merges the data from its input branches
…plus 2 more steps. See the full node list below.
Services it uses
Before you upgrade to n8n 3.0
Nothing in this workflow is removed in n8n 3.0, so it should import and run after the upgrade.
Nodes used (12)
- Schedule Trigger
n8n-nodes-base.scheduleTrigger - Edit Fields (Set)
n8n-nodes-base.set - Code
n8n-nodes-base.code - AI Agent
@n8n/n8n-nodes-langchain.agent - AI Agent Tool
@n8n/n8n-nodes-langchain.agentTool - Structured Output Parser
@n8n/n8n-nodes-langchain.outputParserStructured - OpenAI Chat Model
@n8n/n8n-nodes-langchain.lmChatOpenAi - Switch
n8n-nodes-base.switch - If
n8n-nodes-base.if - Data table
n8n-nodes-base.dataTable - Merge
n8n-nodes-base.merge - Send Email
n8n-nodes-base.emailSend
From the author
How It Works This workflow automates end-to-end medical claims processing using a multi-agent AI orchestration system built on OpenAI GPT-4. It targets healthcare revenue cycle teams, billing departments, and hospital administrators burdened by manual claims…