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            Subagent: Claim Service Assistance

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            Subagent: Claim Service Assistance

            Resolve member and provider queries about claims.

            Required Editions

            Available in: Lightning Experience
            Available in: Enterprise, Performance, and Unlimited Editions with the Agentforce for Health Cloud Add-on license

            Subagent Details

            API Name ClaimServiceAssistance
            Included Agent Actions

            Find Claim

            Get Claim Summary
            Required Setup Set Up Agentforce for Payer Contact Center

            Examples of Utterances That Trigger This Subagent

            • "Find claim 123456 and summarize."
            • "Find the patient's responsibility for claim 12345."
            • “Get claim details for member ID 54321 for the knee replacement on October 12, 2025."
             
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            Salesforce Help | Article