What is an AI intake agent?
An AI intake agent collects required information, follows a structured flow, and sends a complete record to the right team. It is useful when intake depends on fields, eligibility, routing, and documentation.
Structured intake
AI Patient/Claims Intake Agent
Collect required intake details, screen eligibility, gather context, and hand off a complete record to staff. Refract trains this agent on your workflow, approved knowledge, tools, and handoff rules so your team gets more coverage without losing control.
Who it helps
Built for the people already carrying this workflow.
Refract is designed to give teams more leverage, cleaner context, and more reliable follow-through. The agent handles the repeatable parts, while people stay involved where judgment matters.
- Patient intake coordinators
- Claims intake representatives
- Eligibility screeners
- Care coordinators
- Claims support specialists
Workflow
The work this agent can help move forward.
01
Collect required intake fields in a structured order
02
Ask eligibility or routing questions
03
Capture claim or patient context without repeated questions
04
Remind callers about documents or next steps
05
Route the record to the correct staff member or queue
06
Preserve transcript and field history for review
Sample scenario
See how it handles a real conversation.
A representative exchange — what the agent hears, what it asks, what it captures, and when it hands off to a person.
A new patient calls a specialist clinic to complete intake before their appointment next week.
Caller
Hi, I got a message to call and complete some intake information before my appointment.
Agent
Yes, I can take care of that. I'll walk you through the required fields. This usually takes about five minutes. Ready to start?
Caller
Sure.
Agent
First, can you confirm your full name and date of birth?
Caller
Diana Torres, March 12, 1981.
Agent
Thanks Diana. What's your insurance provider and member ID?
Caller
BlueCross. ID is XYZ-88324.
Agent
Got it. Has your primary care physician referred you, or did you self-refer?
Caller
Dr. Patel referred me.
Agent
Last thing: are you currently taking any prescription medications I should note before your visit?
Caller
Just Lisinopril, 10mg.
Agent
Got everything. A care coordinator will review your record before the appointment. If anything looks incomplete they'll reach out before then.
Collected
- Full name (Diana Torres)
- Date of birth (03/12/1981)
- Insurance: BlueCross, member ID XYZ-88324
- Referral source (Dr. Patel)
- Medication: Lisinopril 10mg
Action taken
Intake record created with all required fields. Routed to care coordinator queue. Appointment note updated.
Outcome
Staff start the appointment with a complete intake record. No follow-up calls needed to collect missing fields.
Handoff rule
Would escalate immediately if the caller described acute symptoms, expressed distress, or asked for a clinical decision.
What improves
What gets better when this agent is running.
- More complete intake records
- Shorter intake follow-up loops
- Less repeated data collection
- Cleaner staff handoff in regulated workflows
Connections
System categories it connects to.
CRMEHR or intake systemClaims systemEligibility checkerDocument workflowSecure email or webhook
Specific integrations confirmed at scoping.
Controls
Guardrails that keep it useful.
- No clinical or claims decisions without approved rules
- Verification before sensitive information
- Required-field checks
- Escalation for exceptions, distress, or policy boundaries
FAQ
Questions teams ask before they deploy.
Can one agent support patient and claims intake?
Yes, if the workflows are clearly separated. Refract can use different scripts, required fields, handoff rules, and knowledge sources for patient and claims workflows.
Does the agent make clinical or claims decisions?
No. The agent should collect information, follow approved rules, and route the case. Clinical, legal, or claims judgment should stay with qualified staff.
Can it collect required intake fields?
Yes. Refract can track required fields, ask for missing details, and produce a structured summary for staff.
Can it hand off to staff with a summary?
Yes. Handoff can include the reason for escalation, collected fields, transcript, and recommended next step.
Start here
Map one workflow before you expand the agent.
Bring the process, examples, routing rules, and systems this service needs to use. We will help you decide what should be automated, what should be escalated, and how to prove the first deployment.
Talk through your AI Patient/Claims Intake Agent
Share the workflow, current bottleneck, and tools involved. We will follow up with a practical first-deployment path.