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Set Up Agentforce for Payer Contact Center
To help payer contact center reps deliver efficient patient and provider interactions by using Agentforce, enable the required settings and set up Agentforce for Payer Contact Center.
Required Editions
| Available in: Lightning Experience |
| Available in: Enterprise, Performance, and Unlimited Editions with the Agentforce for Health Cloud and Agentforce Employee Agent add-on licenses |
| User Permissions Needed | |
|---|---|
| To set up Agentforce for Payer Contact Center: | Contact Center Agent for Health Cloud |
To set up Agentforce for Payer Contact Center, complete these prerequisites.
- Set up Einstein Generative AI.
- Enable Agentforce.
- From Setup, go to Health Cloud, and turn on Einstein for Health Cloud.
- Enable Contact Center for Health Cloud.
- Set Up Agentforce for Contact Center.
- Create an Agent for Contact Center.
- In Setup, find and select Contact Center for Health Cloud.
- Select Agentforce for Payer Contact Center.
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Complete the listed steps.
The guided setup links back to this page for additional details to help you complete certain steps.
- Configure Data Streams for Claims Objects
To pull claims data from external systems via a Data 360 zero copy connection, configure claims data streams. - Configure Data Streams for Member Coverage Objects
To define the member coverage data ingested into Data 360, configure member coverage data streams. - Configure Data Streams for Prior Authorization Objects
To pull prior authorization data from external systems via a Data Cloud zero copy connection, configure prior authorization data streams. - Review Payer Contact Center Flows
To support payer contact center processes, review and update claims and member coverage flows. - Configure the Claims Service Assistance Subagent and Actions
To support claim query processes, review, configure, and add subagents and actions to your payer contact center agent. - Review Member Coverage Prompts
To support member coverage queries in payer contact center, review the member coverage prompts. - Create a Member Coverage Data Graph
To bring together structured data from your member coverage Data Model Objects (DMOs), use the Member Coverage data graph. - Configure the Member Coverage Assistance Subagent and Actions
To support member coverage query processes, review, configure, and add subagents and actions to your payer contact center agent. - Configure the Prior Authorization Assistance Subagent and Actions
To support prior authorization query processes, review, configure, and add subagents and actions to your payer contact center agent. - Configure The Provider Network Search Subagent and Actions
To support provider network query processes, review, configure, and add subagents and actions to your payer contact center agent.
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