BenAi

Navigating Healthcare, Simplified

BenAI is a next-generation customer service platform we developed to transform how members understand and interact with their healthcare plans. By combining cutting edge AI with clean UX, BenAI helps members maximize their benefits, reduces administrative load, and enhances support quality for healthcare administrators.

What we built

AI chatbot for plan-specific Q&A
Centralized hub for docs & benefits
Admin tools for TPA workflows
Plan comparison & scenario planning
Scalable, secure, and compliant

Outcomes

Instant answers to member questions
Less load on customer service teams
Smarter plan usage by members
Faster onboarding for new groups
Happier members, fewer escalations

Agentic Architecture

BenAI system diagram

We created a modular agent framework to enable intelligent data retrieval and workflow execution. A central Routing Agent dynamically selects specialized sub-agents—such as Plan Context, Claim Status, and Doctor Network Agents—based on the user's question.

These agents fetch information from relevant data sources (e.g. Group Data, Claims API, Doctor Network) and return structured context to a Summarizer, which formulates a precise, user-facing response. The system is designed for scalability, supporting easy integration of future agents and APIs.