The administrative waste of operating in silos

Most plans run member operations in silos — care management in one system, utilization management in another, appeals & grievance in a third. Each has its own workflow, its own view of the member, and its own staff re-entering the same information.

Members feel it directly. When they have to tell their health story over and over, they notice it when:

• The care manager doesn’t know an appeal is open.
• The UM nurse can’t see the care plan.
• Nobody has the whole picture.

Stop paying for systems that don’t talk to each other.

Unify your core member operations onto a single platform

CareInsight's careassistant.ai consolidates Care Management, Utilization Management, Appeals & Grievance, and LetterIQ into one unified, interdependent ecosystem. By deploying specialized single-function AI agents across these departments, you eliminate the costly “swivel-chair” data entry that consumes up to 60% of clinical staff time.

The platform solution — one platform, four connected products, one continuous member story

Bring your departments together on a shared foundation while maintaining their independent day-to-day workflows. Prior authorizations, clinical appeals, and care plans merge into one continuous member record for each departments to access the same information.

Let AI agents do the work nurses shouldn’t have to do

Intake, Outreach, Clinical Summary, ICP generation, UM Evidence & Recommendation, A&G Decision, Omni-Channel Notification, and more. Visit the Agent Library for all 12 agents.

Each agent automates a specific workflow:

• Intake from any channel in 2 minutes.
• Care plans in 8 minutes instead of 45.
• Appeal evidence assembled automatically.
• Determination letters triggered without manual work.

Human-in-the-loop control

AI agents handle the manual assembly, data entry, and documentation. Your licensed clinicians retain 100% decision-making authority.

Compliance, scale, and fit