AGI.do

Processes

What will AGI do for Determine enrollment eligibility?

An individual or employer group submits an application or request for health insurance enrollment.

Trigger
An individual or employer group submits an application or request for health insurance enrollment.
Outcome
The applicant's eligibility for coverage is formally approved or denied, the system is updated, and the party is notified.

The work itself

Grounded Work Profile

Measured by

  • Determination Cycle TimeprocessProfile
  • Eligibility Decision AccuracyprocessProfile
  • First-Pass Verification YieldprocessProfile
  • Cost Per Eligibility DeterminationprocessProfile

Key steps

  • Receive enrollment application and demographic dataprocessProfile
  • Verify applicant identity and basic informationprocessProfile
  • Assess applicant data against plan-specific eligibility rulesprocessProfile
  • Validate qualifying life events or prior coverage if outside open enrollmentprocessProfile
  • Record final eligibility determination in the core systemprocessProfile
  • Issue formal notification to the applicant or employer groupprocessProfile

How AGI delivers it

Four ways AGI delivers for Determine enrollment eligibility

  • 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 Determine enrollment eligibility connects

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