Agent OS · Cases & Memory
Agents that keep working, and remember what they learn.
Healthcare work doesn’t finish in one conversation. It waits on payers, faxes and patients. Agent OS tracks every piece of it as a case, checks back on your schedule, and remembers what it learns for next time.
Case · Prior auth
Carmen D. · Knee MRI
Finish line: auth approved, procedure confirmed · Deadline: Fri 8:00am
- Mon 9:12TriggerMRI ordered by Dr. Okafor. Case opened, deadline Fri 8:00am.
- Mon 9:20MemoryLakeshore wants PT notes for knee MRI. Attached from the chart, auth submitted.read · payer memory
Memory · this agent’s entities
Patient memory· Carmen D.
- Prefers texts, in Spanish
- Reachable after 5pm
Payer memory· Lakeshore Health Plan
- Wants 6 weeks of PT notes for knee MRI
- Decisions post to the portal by 9am
Referral sourceCustom· Dr. Okafor’s office
- Answers faster by fax than by phone
Cases
A case, not a conversation.
A conversation ends when the patient hangs up. A case ends when the work is done, or when a person takes it over.
Trigger
What opens it
An order, a fax, a call, a denial, a statement nobody paid.
Finish line
What “done” means
Auth approved and procedure confirmed. Not “message sent”.
Deadline
When it’s too late
The procedure date, the appeal window, timely filing.
Check-ins
When to look again
On your schedule. A reply moves it forward right away.
Handoff
Who takes over
The person or team you name, with everything already tried.
- Active
- Waiting
- Resolved
- or
- Escalated
- or
- Failed
- — stops on an error and says so, never quietly.
Your rules
You set the schedule. The agent keeps it.
Each agent gets a check-in ladder: what to try, how long to wait, when to switch channels, and when to stop and hand it to a person. Let the agent pick its own next check-in if you like, always inside your limits.
Every case has a maximum lifetime. When it runs out, the case goes to a person. It never just sits.
Patient Balances Agent · Cases
Check-in ladder
- 1 30 min Send a gentle reminder by text, with the pay link
- 2 4 hrs Try another channel: email the statement
- 3 3 days Call once, in the patient’s preferred hours
- 4 7 days Escalate to the billing team
- Agent may choose its next check-in
- Minimum gap between check-ins
- 30 min
- Maximum case lifetime
- 14 days
- Handoff goes to
- Billing team
MRI Referral Agent · Memory
Memory entities
- Patient memory · preferences, language, contact hours
- Payer memory · what each plan asks for, how it answers
- Referral source Custom · how each office sends orders
- + Add a custom entity
Memory
You decide what each agent remembers.
Give an agent patient memory and payer memory, then add custom entities for anything else it should remember. The agent reads them before it acts and adds what it learns, so the second auth for a payer goes in right the first time.
Patient memory. “Carmen prefers texts, in Spanish, after 5pm.”
Payer memory. “Lakeshore wants PT notes and the X-ray for knee MRI.”
Custom: referral source. “Dr. Okafor’s office answers faster by fax.”
An agent only remembers the entities you give it. A billing agent doesn’t need to know which office faxes orders.
Knowledge, memory and live data
Three kinds of knowing, kept apart on purpose.
Mixing them is how an agent ends up quoting last month’s balance. Agent OS keeps each where it belongs.
Knowledge
What’s true for everyone.
Payer policies, your SOPs, fee schedules, codes. Retrieval (RAG) matched to the shape of the data:
- Exact
- CPT codes, fee schedules, payer IDs
- Semantic
- Payer policy prose, your SOPs
- Hybrid
- A 271 response: part fields, part free text
Sources: uploads, web pages, Google Drive, OneDrive.
Memory
What the agent has learned.
- “This payer wants 6 weeks of PT notes for lumbar MRI.”
- “Dr. Okafor’s office answers faster by fax.”
- “Carmen prefers texts, in Spanish.”
Patient memory, payer memory, and custom entities you define per agent.
Live data
What’s true right now.
- Eligibility and benefits
- Balances and ledgers
- The schedule
Always fetched from the system of record at the moment it’s needed. Never copied into knowledge or memory, so it’s never stale.
Handoffs
When it hands off, your team starts where it stopped.
No “please look into this”. The handoff says what the goal is, what’s been tried, what’s left, and the one decision it needs, in Slack, Teams or the Console.
Prior Auth Agent · Shift Agent
Escalated Carmen D. · Knee MRI · Fri 8:00am
- Goal
- Auth approved before Friday’s procedure.
- Tried
- Submitted Mon with PT notes and X-ray. Portal checked Tue and Wed: pending. Payer line called Thu 10:05, ref #41-7730.
- Needs
- Request a peer-to-peer, or move the procedure?
See a case run on your own EHR.
Bring the follow-up your team chases by hand. We’ll show it tracked, remembered and finished.