Processes

What will AGI do for Perform provider research and resolve inquiries?

A healthcare provider submits an inquiry or dispute regarding a claim, authorization, or contract to the insurance carrier.

Trigger: A healthcare provider submits an inquiry or dispute regarding a claim, authorization, or contract to the insurance carrier.
Outcome: The inquiry is answered, necessary adjustments are initiated, and the final resolution is communicated and documented.

The work itself

Grounded Work Profile

Receive and log the provider inquiryprocessProfile
Verify provider identity and locate the relevant claim or member recordprocessProfile
Research system data, contract terms, and medical policiesprocessProfile
Formulate the resolution or escalate to a specialized departmentprocessProfile
Communicate the finding and subsequent actions to the providerprocessProfile
Document the interaction details in the contact center systemprocessProfile

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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