What Your AI Knows on Every Call

Before your AI says hello, careCycle hands it a snapshot of the member from your records: who they are, their coverage, their appointments, what they've asked for, and how your last few calls went. So when Mary calls back about the ID card she asked about last week, your AI already knows, and it doesn't open a second request or promise a callback nobody scheduled.

This happens on every AI call, inbound and outbound, the Receptionist included. It's automatic. Nothing in your script can turn it off, and you don't need to set anything up.

What it knows before it says hello

Who they are

Their name, age, city, state, and ZIP, their preferred language if it isn't English, and whether they have Medicaid. It also knows whether they called you or you called them.

Their coverage

Up to six of their policies, newest first: carrier, plan, status, effective date, end or cancellation date, paid-through date, premium, and their agent.

Their appointments

Appointments from the last three weeks and any coming up (up to six): when, how, with whom, on which calendar, the status, and what it's for. It knows when an appointment is due right now and they might be waiting, and when one was missed.

It also knows what it doesn't have: your records hold your appointments, not their doctor's.

Their open requests

Their newest inquiries (up to six), and for each one, where it stands: nobody has acted on it yet, the team is working on it, or the team's reply. It also sees up to two requests closed in the past week, with the answer your team gave.

Recent calls

The eight most recent calls from the last 30 days, each with its summary and the teammate who made or took it.

Why you last called them

If one of your campaigns called them in the last 30 days, the AI knows which one, whether it reached them, and what that call was about. So when they call back, it can tell them why you called.

Your office hours

Your hours for the next seven days, holidays and special hours included. After hours, it tells callers you're closed, never that you're busy.

Medicare basics

The AEP and OEP dates, the difference between the carrier and your agency, and the scams going around (like "$250 card" calls). It speaks for your agency as "we."

What it doesn't see

The AI only gets what it needs to help on the call. It doesn't see:

• Texts, staff notes, tasks, tags, or custom fields
• Phone numbers, email, street address, MBI, or member and policy IDs
• Health details, medications, or the reason they bought their plan
• Other people who share their phone number
• Calls older than 30 days, or appointments older than three weeks

Plan benefits come from its plan lookup, not from this snapshot.

It only shares plan, health, and appointment details with the member or someone they put on the line. On outbound calls, it doesn't say why it's calling until the person confirms who they are.

What it can do on the call

Take a note for your team

Every campaign call can leave a note for your team as an inquiry, even if the campaign has no Log Inquiry escalation (those go under General Inquiry). Notes are written like a to-do, in English, and only for real follow-ups. If the member brings up something that's already open, the AI adds to that inquiry instead of opening a new one.

The inquiry goes to the member's assigned agent, who gets a notification, or to the teammate the caller asked for.

Move or cancel an appointment

If the campaign can book appointments (it has a Book Appointment escalation with a calendar), the AI can also move or cancel the member's existing appointments. A moved appointment stays with the same agent, and the member gets a text with the new time. A cancellation lets the agent know.

Offer times

Offered and booked times start with "today" or "tomorrow" when they're that close, so nobody hears "Monday" on a Monday. If they ask for a day you're closed, the AI says so and offers the closest open times.

When an appointment is due now

If a member calls about an appointment that's due now or running late, the AI apologizes and offers to transfer them, when the campaign can transfer. Otherwise it offers the soonest time it can, or leaves an urgent note.

Ask for someone by name

Callers can ask for a teammate by name, like "Can I talk to Dana?" The AI tries that person in the routing group's configured priority order. If they aren't available, it says so and tries the rest. If the caller asks to book with them, it can use that person's calendar, and notes can go to them.

This is off by default. Turn it on for each routing group: open the routing group, and under Agent Priority, turn on Prioritize the agent requested by name. Move it above or below the assigned-agent and last-spoken-to options to choose when that person is tried. See Routing.

Returning callers reach the right team

When someone calls back after one of your outbound campaigns called them in the last 30 days, your inbound AI can transfer them to that campaign's team, even if the Receptionist doesn't transfer calls on its own. It only does this when they're calling about what that call was for.

A callback when nobody's free

If a transfer can't connect because everyone's busy, the AI can offer to have the first person who frees up call them back: "Looks like everyone's tied up with other folks right now. Want me to have the first person who frees up give you a call back at this number?" It only offers during business hours and never promises a time.

Turn it on for each transfer destination under Voice AI Transfer Fallback with Offer a callback first. See Routing.

Keypad presses

Callers can answer by pressing keys on their phone. The first press stops the AI from talking, and presses show in the transcript. The AI never reads out a keypad menu.

Spanish calls

On Spanish calls, the AI says dates in Spanish and uses the right tense for coverage start dates. Notes and summaries stay in English for your team.

Wrong numbers

If the person says it's the wrong number, the AI apologizes and ends the call. A Wrong Number disposition ends the member's journey in that campaign, like an invalid number.

Rules your script can't change

Some rules hold on every call, whatever your script says:

• It never gives a callback time. Someone gets back to the member as soon as they can.
• It never says something is done unless it actually did it.
• After hours, it says you're closed, not busy.
• It can't cancel or change a plan, approve or send a medication, or reach the carrier for the member.

What you control

Everything else on this page is automatic.

Testing it

Simulations in Assembly don't load the member snapshot on this page. If you pick a real customer for a simulation, their details (like their name, agent, and plan) fill in the greeting and script, but the AI won't know their policies, appointments, open requests, or recent calls. Leave the customer blank and it uses a sample customer instead.

To hear the AI use everything it knows, set up your Test Customer with policies and appointments, and run a test call. See Test Your Campaign.