Processes

What will AGI do for Claim Adjudication?

Positioning for this Coordinate is coming soon.

How AGI delivers it

Four ways AGI delivers for Claim Adjudication

  • Autonomous Agents as digital employees

    Hire a digital employee that does the job under earned, supervised autonomy.

    For Claim Adjudication, hire a digital employee that does the job under earned, supervised autonomy.

  • Business-as-Code

    Encode how your work runs, once, as software that executes itself.

    For Claim Adjudication, encode how your work runs, once, as software that executes itself.

  • Services-as-Software

    Get the professional outcome delivered as software, priced on results, not headcount.

    For Claim Adjudication, get the professional outcome delivered as software, priced on results, not headcount.

Value flow

How Claim Adjudication connects

automated by

measured by

  • First Pass Adjudication Ratemodel
  • Payment Accuracy Ratemodel

produces

optimizes (incoming)

  • Number of invalid or fraudulent claims that are approved per $1 million revenuemodel
  • Percentage of total claims processed that is rejectedmodel
  • Percentage of total claims processed that is approvedmodel
  • Payout Accuracymodel
  • Benefit Payment Accuracymodel