Build and deploy governed agents for healthcare payor workflows
Bring a priority payor workflow and leave with a clear plan for deploying agents across the required systems, policies and review boundaries.
You leave with
FacilitatorBalaji Nagaraj Kumar · VP, AI Engineering, MoringGet started
Tell us the workflow and the constraint. We reply within one business day.
Three to five people from the teams the workflow touches.
Bring the claims, underwriting, compliance and technology teams involved in the workflow. Be ready to map the handoffs, exceptions and decisions that determine how it runs.
Five payor workflow agents to explore
Prior-auth evidence agent
Pulls policy, clinical criteria, chart and correspondence into one cited file so the review starts from a complete picture.
Claims triage agent
Reads the intake, history and attachments; assembles a review-ready file and routes only what needs a person.
Revenue-cycle agent
Runs eligibility, coverage and coding checks behind a claim and flags only what needs a person.
Grievance and appeals agent
Reconstructs the authorization, treatment and communication history behind an appeal inside the regulatory clock.
Provider data agent
Keeps the directory, credentialing and network data consistent and flags the conflicts for review.
Workshop agenda: one workflow.
Outcome and ownership
What problem, whose workflow, what it costs you today, and what better looks like.
How it runs now
The intake, the evidence, the systems, the policy checks, the decisions and the referrals.
Agent and human split
What the agent does, which decisions stay with your licensed people, and what stops it.
Controls for production
Identity, access, approvals, monitoring, cost limits, rollback and a kill switch.
Testing and measurement
The cases you would test it on, how it handles missing information, and the baseline you judge it against.
First scope
The smallest version worth proving, what counts as success, and what happens after.