How Cora Answers Plan Questions
careCycle maintains Medicare Advantage plan benefit data, so Cora can verify answers in real time. Nothing for you to upload.
careCycle maintains its own dataset of Medicare Advantage plan benefits. You do not upload or manage plan data. When you import your book of business or connect your CRM or Enhanced Direct Enrollment (EDE) platform, the plan codes on your policies link each member to their plan's benefits automatically.
This means that in real time, Cora can query benefits and verify answers before providing them to a member. Whether the question is about copays, deductibles, out-of-pocket maximums, drug coverage, or primary care providers (PCPs), Cora can either get your member the answer, or get them to you to provide it.
What Gets Answered
Cora can address:
- Copays and cost-sharing
- Deductibles and out-of-pocket maximums
- Drug coverage
- Primary care providers (PCPs) and network questions
When an answer is outside the AI employee's scope, the conversation is escalated per your settings (transfer, appointment, or inquiry).
What You Need to Do
Just one thing: make sure your policies carry accurate plan codes. That is part of the normal book of business import.