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Agentforce and Einstein Generative AI
Health | Find Provider Claims

Health | Find Provider Claims

Retrieves claim records for a healthcare provider from an external zero copy system based on the provider NPI, service start date, and service end date. Optionally, filters by member number, claim status, preauthorization ID, or claim ID. Returns up to the 20 most recent claims.

Required Editions

Available in: Lightning Experience
Available in: Enterprise, Performance, Unlimited, and Developer Editions with the Agentforce for Health add-on or included in Agentforce 1 Health Edition. Requires each user to have the Agentforce for Health add-on to access the action.
User Permissions Needed  
To use this action:

Use Contact Center AI Assistive Agent

AND

Contact Center Agent for Health Cloud permission set

AND

Prompt Template User

AND

Data Cloud User

See Common User Access for Standard Agent Actions.
Note
Note The user interface of this product is available only in English and may not be fully supported in other languages.

Action Details

API Name FindProviderClaims
Reference Action Type Flow
Does this action run one or more prompt templates? No
Required Setup Set Up Agentforce for Payer Contact Center
 
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