Eligibility and benefits
Ground responses in plan documents, eligibility files, and approved operating rules.
Support Agent
Healthcare support answers with plan-level evidence
Resolve eligibility, benefits, claim-status, enrollment, renewal, member, provider, and broker questions with cited answers grounded in each plan and operating rule.
What Support Agent handles
Claim and renewal status
Pull status context from cases, packets, queues, and workflow history.
Provider and broker support
Draft consistent responses while preserving escalation paths for complex cases.
Human handoff
Escalate with sources, issue summary, prior messages, and recommended next step.
Designed for support operations
Shorter queues
Routine requests are resolved without forcing operators to search every system.
Consistent language
Answers follow plan-specific wording and approved knowledge.
Controlled automation
Teams decide which answers send automatically and which require approval.