Clinical Intake & Triage Agent
Answers patients at any hour, asks about their symptoms, judges how urgent the case is and directs them to the right care.
The challenge
Each case needs someone to gather the evidence, check it against the rules and decide. Simple cases wait in the same queue as difficult ones.
How it works
- 1A case arrives.
- 2The agent gathers the evidence and the rules that apply.
- 3It assesses the case and recommends a decision, with its reasons.
- 4Simple, low-risk cases within your limits go ahead.
- 5Everything else goes to your approver with the evidence laid out.
- 6The decision and the reasons are recorded in your system.
Your people stay in control
You set the limits. Only simple, low-risk cases inside those limits go ahead automatically. Everything else is decided by your approver.
Systems we work with in Healthcare
- Electronic health records via FHIR and HL7
- Practice management and scheduling
- Payer portals and clearing houses
- Contact-centre telephony
- Imaging and lab systems
How we measure success
- How often the agent agrees with your experts
- How many cases are cleared without waiting
- How quickly decisions are made
Kind of work
Decisions and approvals. The agent gathers the evidence, recommends a decision, and passes anything that is not simple to a person.
More in Healthcare
Claim Denial Management AgentReads why an insurer refused a claim, writes the appeal with supporting evidence and resubmits it.Medication Reconciliation AgentCompares the medicines a patient takes at home, in hospital and on discharge, and warns of duplicates, clashes and gaps.Clinical Documentation Integrity AgentReviews charts for missing specificity before coding and sends the clinician a short, compliant query.Prior Authorisation AgentPrepares and submits requests for insurer approval of treatment, then follows them up, so staff handle only the exceptions.
Want this working in your organisation?
We can show it working on real examples from your business before you commit to a full build.