https://catalogartifact.azureedge.net/publicartifacts/sonata-software-ltd.benefit_inquiry_agent-de9c5d40-0ed6-4371-a7c3-d320742db77b/398427b3-ea31-481d-b723-f2c099263e3c_Sonatalogo216.png

Benefit Inquiry Agent

door Sonata Software Ltd.

Instant access to member and plan data for fast, precise benefit insights.

Overview

The Benefit Inquiry Agent enables customer service teams to instantly retrieve member and plan details to answer benefit-related questions quickly and accurately. By connecting with policy administrative platforms such as Facets and integrating with Dynamics 365 Customer Service, the agent consolidates relevant data and delivers real-time responses during member interactions.

Designed for customer service representatives and member services teams, the agent eliminates the need to navigate multiple systems. It automatically retrieves contextual member and plan information, allowing agents to respond to benefit inquiries faster while improving accuracy and consistency.

Challenges

  • Customer service representatives navigate multiple screens to find member and plan details, slowing inquiries
  • Lack of automatic context increases errors
  • Large datasets cause slow query responses
  • Failures lead to missing or incomplete data

Key capabilities

  • Seamless initiation: Launches directly from the Dynamics 365 Customer Service interface
  • Automatic contextualization: Instantly retrieves member and plan profiles from D365 and external policy administrative platforms
  • Dynamic indexing: Creates session-based index for rapid plan summary queries
  • Robust fallback: Uses a pre-existing plan summary query as backup for data availability

How it works

  • Agent launch: The Benefit Inquiry Copilot is launched directly from the Dynamics 365 customer service interface for quick access.
  • Context retrieval: The agent automatically retrieves the relevant member profile and plan details from Dynamics 365 and connects to policy administration platforms such as Facets to fetch real-time benefit and plan data.
  • Dynamic indexing: After retrieving data from Dynamics 365 and Facets, the agent creates a temporary, session-based index table for plan summary data to enable rapid query responses.
  • Query handling: The agent processes benefit-related questions and provides instant, accurate answers using indexed data.
  • Fallback mechanism: If indexing fails, the agent uses the pre-existing plan summary query as a backup to ensure data availability.
  • Response delivery: The agent delivers clear, actionable benefit information back to the user in real time.

Business impact

  • Provides instant access to member and plan details, reducing navigation time.
  • Automatically applies context, minimizing errors and improving accuracy.
  • Speeds up responses with session-based indexing for large datasets.
  • Ensures uninterrupted data availability through a reliable fallback mechanism.

Who benefits

  • Members
  • Customer service representatives
  • Member services agents
  • Supervisors and team leads
  • Support analysts

Een overzicht

https://catalogartifact.azureedge.net/publicartifacts/sonata-software-ltd.benefit_inquiry_agent-de9c5d40-0ed6-4371-a7c3-d320742db77b/3bd0d92f-c362-4774-ae12-3639662e5ccc_BenefitInquirypng.png