Processes

What will AGI do for Develop and maintain medical policies?

A new medical technology emerges, clinical guidelines change, or a scheduled policy review cycle begins.

Trigger: A new medical technology emerges, clinical guidelines change, or a scheduled policy review cycle begins.
Outcome: A finalized medical policy is published to stakeholders and integrated into the claims adjudication system for coverage determinations.

The work itself

Grounded Work Profile

Monitor medical literature, technology assessments, and regulatory changesprocessProfile
Draft new or revised medical policy criteria based on clinical evidenceprocessProfile
Assess financial and clinical impact on current member populationsprocessProfile
Submit drafted policy to clinical governance and medical directors for reviewprocessProfile
Approve and finalize the medical policyprocessProfile
Update claims adjudication rules to reflect the new policyprocessProfile
Publish the updated policy to provider and member portalsprocessProfile

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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