Processes

What will AGI do for Process prior period membership eligibility-related adjustments?

A notification is received indicating a discrepancy in a member's past enrollment status or coverage effective dates.

Trigger: A notification is received indicating a discrepancy in a member's past enrollment status or coverage effective dates.
Outcome: The member's historical eligibility profile is updated and corresponding adjustments to past premiums and claims are routed for processing.

The work itself

Grounded Work Profile

Receive retrospective eligibility update from an employer group, government exchange, or memberprocessProfile
Validate the qualifying event and effective dates for the prior period changeprocessProfile
Update the core membership database with corrected historical coverage timelinesprocessProfile
Identify past claims and premium invoices affected by the retroactive date changeprocessProfile
Initiate recoupment or reprocessing workflows for impacted financial recordsprocessProfile
Generate updated enrollment confirmation and billing statements for the member or groupprocessProfile

How AGI delivers it

Services-as-Software
Get the professional outcome delivered as software, priced on results, not headcount.
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Autonomous Agents as digital employees
Hire a digital employee that does the job under earned, supervised autonomy.
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Business-as-Code
Encode how your work runs, once, as software that executes itself.
Platform.do

Value flow

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