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AI Capabilities

AI finds what needs attention and moves the work forward, people make the call.

Under everything is AssureCare’s clinical AI layer. It turns claims, clinical documents, pharmacy and SDoH data into governed agent actions inside the workflows your teams already use.

the engine underneath

Agents that sense, decide, act — and learn.

01

Sense

Continuously ingests claims, ADT feeds, EHR documents, pharmacy fills and SDoH into one longitudinal member record.

FHIR R4 · HL7v2 · X12Unstructured-note NLP
02

Decide

Predictive models and policy-grounded reasoning rank risk, match criteria and recommend the next best action — with citations.

Explainable scoresPolicy & criteria grounding
03

Act

Agents execute: draft determinations, place outreach calls, build care plans, schedule CMRs — within guardrails you set.

Configurable autonomyClinician sign-off gates
04

Learn

Every outcome, override and appeal feeds back into monitoring — so models improve and drift is caught before it matters.

Bias & drift monitoringFull audit trail
See it on your data

Put AI agents to work this quarter.

Bring a workflow — prior auth, transitions of care, adherence outreach. We'll show you what an AssureCare agent does with it in a 30-minute session.