AGI.do

Processes

What will AGI do for Receive member service grievances?

A health plan member submits a formal complaint regarding a service issue via phone, mail, or digital portal.

Trigger
A health plan member submits a formal complaint regarding a service issue via phone, mail, or digital portal.
Outcome
The grievance is formally logged, categorized, acknowledged to the member, and routed to the appropriate resolution team.

The work itself

Grounded Work Profile

Measured by

  • Grievance Logging Cycle TimeprocessProfile
  • Acknowledgment Compliance RateprocessProfile
  • Categorization AccuracyprocessProfile

Key steps

  • Receive member grievance via inbound channelprocessProfile
  • Verify member identity and active plan detailsprocessProfile
  • Log grievance details into the tracking systemprocessProfile
  • Categorize the grievance by type and severityprocessProfile
  • Issue formal acknowledgment of receipt to the memberprocessProfile
  • Route the case to the designated resolution or appeals departmentprocessProfile

How AGI delivers it

Four ways AGI delivers for Receive member service grievances

  • 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 Receive member service grievances connects

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