Find and summarize claim and member coverage details quickly by using Agentforce for Payer Contact Center. Increase efficiency by updating athenahealth patient records directly from Health Cloud.
- Use Agentforce for Health Cloud in Government Cloud Orgs
Agentforce for Health Cloud features are now available in a Government Cloud or Government Cloud Plus environment. - Access Member Plans and Eligibility Data by Using Agent Actions
Help your payer contact center reps quickly address member and provider questions about coverage, eligibility, and cost shares. New member coverage actions use structured data from Data 360 to summarize and query coverage details, so your reps can accurately address common member concerns about plan details and covered services. - Add Agentforce to Payer Contact Center Quickly
Set up Agentforce for your payer contact center by using a guided setup, and make sure that your contact center reps are productive from day one. Create a data graph, review flows, and configure agent topics and actions by following the easy-to-understand steps. Stay focused and on task by using the direct links to the in-app setup pages and comprehensive help articles. - Resolve Claims Queries Faster by Using Data 360 Zero-Copy Claims Actions
Give your payer contact center reps the tools to resolve member and provider claims queries more efficiently by using adjudicated claims data. By using Data 360 claims actions, agents can now fetch adjudicated claim records directly from external systems via zero-copy integration. Agents can use the adjudicated claim records to provide payer contact center reps quick access to high-level summaries and specific claim details, such as status, denial reasons, and patient responsibility. - Update athenahealth Patient Records Directly from Health Cloud
Connect Health Cloud and the athenahealth Electronic Health Records (EHR) to support real-time data write-back for patient records. Eliminate context switching and duplicate data entry, and give your care team immediate access to the most current patient data. Improve the efficiency and the overall quality of care by helping your care team capture and share the most up-to-date patient information from your Health Cloud org. - Manage Patient Updates Faster with Agentforce for Provider Contact Center
Streamline case handling, reduce repeat calls, and ensure accurate patient data by managing key updates directly within Agentforce. Help your contact center reps quickly add caregiver details, update patient information such as demographics and caregiver information, and send medication refill requests, all in one place. Strengthen service quality by ensuring reps always have current patient information, enabling faster and more efficient patient interaction, smoother hand off across teams, and stronger first-call resolution. - Intelligent Document Processing Is Now Document AI for Health
The Intelligent Document Processing feature is now called Document AI. All existing document extraction capabilities remain unchanged. - Support Diverse Healthcare Document Types with Custom Document Extraction Templates
Help your public health investigators and case intake specialists process a wider range of documents, including PDF, JPG, and PNG files, by using custom extraction templates for specific healthcare scenarios. Improve operational efficiency, reduce manual data entry, and get faster access to accurate, structured data that maps correctly to your Health Cloud data model. - Review the Accuracy of Extracted Data with Confidence Scores
Improve extraction accuracy and save review time with a confidence score next to each extracted field. Help your public health investigators and case intake specialists identify values that fall within a defined low-confidence range and require an additional manual review. Strengthen validation, minimize errors, and maintain high-quality health records by concentrating efforts only on fields that require attention. - Preview and Validate Extraction in Real Time
Ensure faster and accurate template creation by using a real-time playground to validate extraction behavior and experiment with prompt variations during template setup. Preview extracted results instantly by uploading a sample file to confirm the accuracy of the results before saving them. Identify missing or incorrect fields early in the process to reduce trial and error. Improve data quality and deliver cleaner, structured outputs that align with the Health Cloud data model.