Optyzone

Payer Policy Search Agent

Answers staff questions about coverage with up-to-the-day policy citations.

RAGComplianceCitations
Payer Policy Search Agent
Polished agent demo — preview
Agent running
Agent thinking
  1. 1Reading inputs and pulling relevant context across systems…
  2. 2Building a plan: 4 steps, 2 tools, 1 human approval gate.
  3. 3Executing steps with progress streaming back to the user.
  4. 4Decision made. Drafting summary and queuing for review.
This demo is a polished preview. Book a build to see the production version.

The problem

Coverage policies change weekly across hundreds of payers. Front-office staff guess wrong and patients get surprise bills.

What the agent does

  • Ingests payer policy PDFs and bulletins on a daily cadence
  • Answers natural-language coverage questions with direct citations
  • Flags policies that recently changed and impact in-flight authorizations

Business value

Cuts coverage-question wait times from days to seconds and reduces surprise-billing complaints by 65%.

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