Beyond AI agents: the next CX horizon begins September 18th
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GenerativeAgent for health insurers

Automated member service that’s safe, secure, and compliant

An AI agent that goes beyond canned answers

GenerativeAgent handles nuanced conversations and resolves members’ issues on its own over voice or chat.

Update member information
Explain coverage details
Find an in-network provider
Update prior authorizations
Respond to claims inquiries
Formulary tier and cost sharing information
Graph showing 91% First Contact Resolution.

Improve member service without increasing headcount

Faster, more convenient service for members. Reduced volume to human agents and lower cost for your contact center.

Eliminate long hold times

No more waiting for the next available representative. GenerativeAgent scales to meet demand 24/7, so members connect and get service right away, even during busy enrollment periods.  

Simplify enrollment

GenerativeAgent answers questions about coverage and plan comparisons. New members get what they need to choose the right plan, without additional burdens for your representatives.

Offer 24/7 status updates

Give members efficient updates on claims and pre-authorizations any time of day. GenerativeAgent can explain status and next steps so members can navigate the process easily. 

Help members stay in-network

Simplify the search for an in-network provider with conversational service. GenerativeAgent helps members find a provider who will keep costs down – for them and for your business.

Built to handle the complexity of regulated industries

GenerativeAgent maintains compliance while it safely navigates complex multi-step interactions.

Simplified integration

GenerativeAgent integrates easily into your current infrastructure and uses existing APIs to connect with internal systems. 

With a novel API transformation layer, GenerativeAgent can use your APIs just as they are, making deployment faster and less reliant on development resources.

Security and compliance

GenerativeAgent stays on task and in scope. It creates a detailed record of every interaction, including the conversation, actions taken, and its reasoning.

And it knows when to consult a human representative for guidance and approvals.

Limitless scale on demand

GenerativeAgent scales to meet demand. No more jammed queues or frustrated members during open enrollment periods.

Unmatched safety and security

GenerativeAgent keeps PHI private and secure as it serves your members. Advanced encryption, redaction, and intrusion detection systems protect member data.

Industry-leading safety mechanisms mitigate hallucinations and prevent jailbreaking. Real-time conversation monitoring and a complete action log provide full traceability.

Young lady talking on the phone with GenerativeAgent.