Processes

What will AGI do for Perform benefits management?

A new health insurance product is designed, a group policy is sold, or a regulatory mandate requires coverage updates.

Trigger: A new health insurance product is designed, a group policy is sold, or a regulatory mandate requires coverage updates.
Outcome: Benefit structures are active in the core administrative system for claims adjudication and accurately documented for members.

The work itself

Grounded Work Profile

Intake benefit design specifications and coverage mandatesprocessProfile
Configure copayments, deductibles, and out-of-pocket maximums in the core systemprocessProfile
Map diagnosis and procedure codes to specific benefit tiers and network levelsprocessProfile
Run simulated claims to test adjudication accuracy against the new benefit rulesprocessProfile
Deploy the validated benefit configuration to the production environmentprocessProfile
Publish the summary of benefits and coverage documents for membersprocessProfile

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

Value flow

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