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Processes

What will AGI do for Process intake of claims?

A healthcare provider or policyholder submits a claim for medical services via electronic data interchange, web portal, or paper mail.

Trigger
A healthcare provider or policyholder submits a claim for medical services via electronic data interchange, web portal, or paper mail.
Outcome
The claim is digitized, validated for basic completeness, assigned a tracking number, and routed to the adjudication system.

The work itself

Grounded Work Profile

Measured by

  • First-Pass Acceptance RateprocessProfile
  • Intake Cycle TimeprocessProfile
  • Electronic Intake PercentageprocessProfile
  • Intake Exception RateprocessProfile

Key steps

  • Receive electronic and paper claim submissionsprocessProfile
  • Scan and digitize paper claims via optical character recognitionprocessProfile
  • Validate basic claim data against member and provider databasesprocessProfile
  • Identify and flag missing or malformed informationprocessProfile
  • Assign a unique claim control numberprocessProfile
  • Route the validated claim to the adjudication queueprocessProfile

How AGI delivers it

Four ways AGI delivers for Process intake of claims

  • 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 Process intake of claims connects

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Go deeper

Explore Process intake of claims

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