Processes

What will AGI do for Review claim experience?

A scheduled reporting interval begins or an underwriter requests an analysis of a specific employer group's claims history.

Trigger: A scheduled reporting interval begins or an underwriter requests an analysis of a specific employer group's claims history.
Outcome: A verified claim experience report detailing cost drivers and utilization trends is delivered to stakeholders for pricing and care management decisions.

The work itself

Grounded Work Profile

Extract historical claims and member enrollment dataprocessProfile
Normalize and categorize claims by diagnostic and procedural codesprocessProfile
Analyze utilization patterns and emerging cost trendsprocessProfile
Benchmark group experience against demographic normsprocessProfile
Identify high-cost claimants and potential network leakageprocessProfile
Compile and distribute actionable claim experience reportsprocessProfile

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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