Plan a pilot

How the practice’s agent works

One question.
Context at every step.

An insurance case begins with what the practice needs to know. Patient details, practice instructions, permitted tools, and the purpose of the inquiry guide the work.

One insurance caseIllustrated product direction
Patient + practiceWhat does this plan report for this visit?Patient · policy · service · date
Permitted sources
Electronic checkStart with the payer response
Additional informationChoose for the specific gap
ConversationOnly with approval
Back to the practiceA supported finding.

What the source reported.
What remains open.

Source · checked at · next action
Each attempt stays attached to the original question. Additional-source and insurance-conversation workflows are product direction.

A representative case · intended workflow

A scheduled visit. An unanswered service benefit.

  1. 01

    Prepare the case.

    Identify the patient, subscriber, payer, provider, service, and date needed for the question.

  2. 02

    Check electronically.

    Start with an appropriate eligibility and benefits inquiry, such as X12 270/271.

  3. 03

    Understand the result.

    Read coverage, benefits, payer messages, errors, and information the response did not return.

  4. 04

    Resolve what remains.

    Choose an authorized follow-up route for the reason the question remains unanswered.

  5. 05

    Return the finding.

    Give the practice the answer, its source, the time checked, and any next action.

Today, staff initiate the electronic check and review the result. Autonomous orchestration of the full case journey is product direction.

Practice configuration

The practice sets the boundaries.

Vocari’s conversational agent uses practice instructions, maintained knowledge, and configured capabilities. Approved tools validate their inputs before taking an action.

For insurance cases, the intended workflow applies those permissions to each follow-up. Access to one source should never imply permission to use every portal or contact every payer.

An unanswered benefit, conflicting policy information, or a matter requiring judgment should return to staff with the context already collected.

Interpret before acting

The next action depends on what is missing.

01 / Starting pointElectronic checkWhat did the payer return?
02 / InterpretationWhat is still unknown?The reason determines the route.
03 / Appropriate follow-upOne question. The right source.Within practice permissions.

Missing member detailClarify patient or subscriber information.

Unclear benefitSeek service-specific information from an authorized source.

Source unavailableKeep the check unresolved for retry or staff review.

Illustrated routing principle. An error does not automatically trigger a call. Autonomous insurance follow-up is not available today.

Conversation and human handoff

Ask a specific question.
Keep a person in control.

A conversation is useful when it can obtain or clarify a particular detail. The product direction connects a practice-approved patient or payer conversation back to the same insurance case.

The conversational agent exists today. Autonomous payer calls, insurance-detail outreach, and portal sessions are not connected insurance capabilities today. A person remains responsible for questions that cannot be confirmed.

Explore the existing scheduling conversation

Give your team an answer they can trace.

Tell us where insurance work slows your practice down. We’ll walk through the questions, payer mix, and workflow that matter to your team.

Plan a pilot