Processes

What will AGI do for Agree on pre-adjudication approach and technology?

A strategic initiative, system migration, or high downstream denial rate necessitates a new or updated front-end claims scrubbing strategy.

Trigger: A strategic initiative, system migration, or high downstream denial rate necessitates a new or updated front-end claims scrubbing strategy.
Outcome: A formalized pre-adjudication strategy, including the selected technology stack and business rule framework, is approved for implementation.

The work itself

Grounded Work Profile

Evaluate current claims intake and front-end scrubbing capabilitiesprocessProfile
Identify gaps in eligibility verification and coding editsprocessProfile
Assess potential technology solutions and rules enginesprocessProfile
Define the required business rules and EDI edit parametersprocessProfile
Align IT and claims operations stakeholders on the proposed technologyprocessProfile
Finalize and document the agreed-upon pre-adjudication architectureprocessProfile

How AGI delivers it

Services-as-Software
Get the professional outcome delivered as software, priced on results, not headcount.
Services.do
Autonomous Agents as digital employees
Hire a digital employee that does the job under earned, supervised autonomy.
Agents.do
Business-as-Code
Encode how your work runs, once, as software that executes itself.
Platform.do

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