AGI.do

Services

What will AGI do for Health or hospitalization insurance?

Positioning for this Coordinate is coming soon.

The work itself

Grounded Work Profile

Tools

  • Policy Administration SystemserviceBlueprint
  • Provider Network SystemserviceBlueprint
  • Pre-Authorization SystemserviceBlueprint
  • Claims Adjudication SystemserviceBlueprint
  • Billing And Payments SystemserviceBlueprint
  • Member PortalserviceBlueprint

Outputs

  • Pre-Authorization RecordserviceBlueprint
  • Inpatient Claims LedgerserviceBlueprint
  • Coverage Determination NoticeserviceBlueprint

Measured by

  • Pre-Authorization Response TimeserviceBlueprint
  • Claims Settlement TimeserviceBlueprint

Key steps

  • Enrol member in planserviceBlueprint
  • Verify hospital network eligibilityserviceBlueprint
  • Authorize hospital admissionserviceBlueprint
  • Adjudicate inpatient claimserviceBlueprint
  • Settle provider paymentserviceBlueprint
  • Notify member of coverage outcomeserviceBlueprint

How AGI delivers it

Four ways AGI delivers for Health or hospitalization insurance

  • 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

Value flow

How Health or hospitalization insurance connects

absorbs

  • Hospital Bill Settlement Administrationmodel
  • Hospital Billing Reconciliationmodel

composes

measured by

  • Claims Accuracy Ratemodel
  • Claims Cycle Timemodel
  • Pre-Authorization Response Timemodel
  • Settlement Cycle Timemodel

optimizes

  • Cashless Approval Ratemodel
  • Claims Settlement Timemodel
  • Medical Loss Ratiomodel
  • Network Coverage Breadthmodel

produces

  • Coverage Determination Noticemodel
  • Hospital Claims Ledgermodel
  • Inpatient Claims Ledgermodel
  • Pre-Authorization Recordmodel
  • Settlement Statementmodel

realizes

Go deeper

Explore Health or hospitalization insurance

Read the deeper take on agi.asView as markdown