Processes

What will AGI do for Collect data related to Medicare and exchange business?

A regulatory reporting cycle begins or a mandate requires Medicare and exchange data compilation.

Trigger: A regulatory reporting cycle begins or a mandate requires Medicare and exchange data compilation.
Outcome: Aggregated, validated datasets are fully formatted and staged for CMS or health exchange submission.

The work itself

Grounded Work Profile

Measured by

Data Completeness PercentageprocessProfile
Data Accuracy RateprocessProfile
Collection Cycle TimeprocessProfile
Format Compliance RateprocessProfile

Key steps

Identify required member, claims, and financial data elementsprocessProfile
Extract source data from core administrative and clinical systemsprocessProfile
Map extracted data to CMS and state exchange regulatory schemasprocessProfile
Identify and resolve missing, duplicate, or erroneous data fieldsprocessProfile
Compile finalized datasets into required transmission formatsprocessProfile
Stage and encrypt datasets for secure external submissionprocessProfile

How AGI delivers it

Four ways AGI delivers for Collect data related to Medicare and exchange business

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

Value flow

How Collect data related to Medicare and exchange business connects

automated by

Aggregating Claims Datamodel
Extracting Enrollment Recordsmodel
Ingest Enrollment Feedsmodel
Reconcile Membership Recordsmodel
Validating Eligibility Datamodel
Claims Data Platformmodel
Government Programs Data Platformmodel
Health Plan Administration Systemmodel
Health Plan Data Warehousemodel

Go deeper

Explore Collect data related to Medicare and exchange business

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