AI review and escalations

Voice → AI review

Lists calls whose AI-drafted note is waiting for a person, or whose proposed next steps are waiting for a decision. Supervisors and administrators see every call; others see their own calls and items routed to them.

The note is the main written record of a call, separate from the transcript. It has fixed sections: the reason for the call, the recipient, date and duration, a summary, what the call established, the outcome, reference numbers, commitments made, missing requirements and the actions that followed.

To review, correct the summary and the outcome if needed, add a reviewer note, and save. The reviewed note is saved as a new version; the earlier version is kept, not overwritten. If nothing could be drafted for a call, the page says so and a person writes the note.

You can review the note on your own calls. Supervisors and administrators can review any call's note.

Next steps - tasks, follow-ups and status changes - are built by fixed rules from the call's outcome, not by the AI. Each one shows what it would do, why, who it is routed to, when it is due and its priority.

Some outcomes do not change a status at all. For example, when a payer says documents are missing for an authorization, the call records the payer contact on the authorization, creates a task to send the missing documents, and schedules a follow-up call. A payer saying a claim is paid or denied creates a task to check against the remittance; payments are never posted from a call.

Proposals are decided by supervisors and administrators, or by the person a proposal is routed to.

When a call creates a task to send missing documents, the follow-up is first scheduled from the task's due date, as an estimate. When the task is marked complete, the follow-up moves to the actual completion date plus the use case's follow-up interval in business days. For authorizations, that is three business days after the documents were submitted.

Only document and missing-information tasks move the follow-up. Finishing a call-back task does not.

Voice → Escalations

High-risk calls go to supervisors: a dispute, a legal or regulator mention, a safety concern, a request for a person, or uncertainty about who was reached. A caller can also choose Escalate to a supervisor on the call page.

A supervisor or administrator reviews the call and chooses Mark resolved. Until it is resolved, an escalation with a legal or identity-related signal (for example, a legal threat or uncertainty about who was reached) blocks further calls to the same person or number. A patient-safety escalation does not block a person calling back, because that call may be the point.