Inquiries
Human expertise. AI availability. Together at last.
Resolve complex member questions with speed, accuracy, and confidence.
When questions go beyond the basics.
Members get accurate answers without delays or repeated explanations.
Most member care systems fail when questions require judgment, verification, or compliance awareness. Either AI guesses, or everything is pushed to humans too late.
Inquiries change that.
When an AI assistant encounters a question it should not answer alone, it creates an Inquiry directly in the member timeline. The full conversation, member profile, and policy context are already attached.
Human expertise enters exactly where it is needed.
The questions that require real expertise.
AI stays helpful without overstepping. Agents focus on what only humans can do.
Inquiries are designed for moments where accuracy matters more than speed alone.
They are triggered when members ask questions that require comparison, verification, or interpretation. This includes evaluating different plan structures, confirming whether a doctor or pharmacy is in network, understanding out-of-pocket costs or prescription coverage, and handling compliance-sensitive forms or authorizations.
These are not edge cases. They are the moments where clarity, confidence, and trust are earned.
AI prepares. Humans decide.
Fast resolution without sacrificing accuracy or compliance.
When an Inquiry is created, the AI assistant drafts a proposed response using verified policy data, benefit summaries, and external sources.
Agents review the drafted answer inside the Inquiry, apply judgment, and approve it with one click. Agents can also place a manual callback when needed. All calls, whether placed by AI or humans, are recorded, analyzed, and transcribed.
Once approved, the AI assistant can call or message the member back with the verified answer.
Everything needed to answer correctly.
Agents act with confidence instead of reconstructing context.
Each Inquiry lives directly inside Unified Inbox and includes the full conversational history, prior outreach, notes, and live member and policy data alongside it.
Agents see what the member asked, how the AI responded, why escalation was required, and the exact customer and plan information used to prepare the answer. The inbox provides the context agents need to guide decisions and respond with confidence.
Close the loop automatically.
Nothing falls through and members receive clear closure.
Once an Inquiry is resolved, the outcome is recorded directly in the member timeline.
Agents decide how the member is contacted. They can dispatch a careCycle AI callback using the approved response or place a manual callback via softphone. Both AI and human calls are recorded, analyzed, transcribed, and added to the same timeline.
All follow-ups are logged alongside the original question, creating a complete and auditable record.
Better answers build long-term trust.
Trust compounds across the entire member relationship.
Members remember the moments when things were confusing or high-stakes.
Inquiries ensure those moments are handled with care, speed, and accuracy. AI provides availability. Humans provide judgment. Members receive answers they can trust.
Inquiries
Inquiries turn complex member questions into coordinated resolution. AI handles availability. Humans provide expertise. Every answer is grounded in context and verified before it reaches the member.
Frequently asked questions
Inquiries are created when a question requires judgment, verification, or compliance awareness. Escalation rules can be configured to match your team’s needs.
Inquiries live directly inside Unified Inbox as part of the member timeline, alongside conversations, tasks, and outreach. They are not separate objects or workflows. Each Inquiry stays connected to the member relationship so context, ownership, and resolution are always clear.
Yes. Agents can place manual callbacks directly from the Inquiry. Those calls are recorded, transcribed, and added to the same timeline as AI calls.
Yes. Once an answer is approved, AI assistants can automatically follow up with the member by call or message, and the outcome is recorded in the timeline.
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