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Use case · advocacy-case-agent

Patient healthcare-bill advocacy

A member hands over a shoebox of hospital bills, insurance explanations, and collection letters. The central question is usually whether a “repriced” bill was ever actually paid — and the provider's own portal is often wrong. Cases run for months, waiting-heavy, with appeal windows and charity-care deadlines ticking.

01 The work arrives — often on its own

Cases don't start clean. A member uploads whatever they have — crumpled statements, a photo of an EOB, a collections letter — through the member portal, or a case opened in Salesforce or Zendesk starts it automatically. Either way, the moment it lands the job becomes a durable task: months of waiting, replies, and deadlines will hang off this one thread.

02 Grain fans out

Grain reads the whole shoebox before it forms an opinion. Documents are classified by what they are, not what they're named; bills are lined up against insurance explanations and bank receipts; every charge code is audited; and a deadline clock starts on the appeal window and the charity-care application. The deciding question in most cases — was the repriced bill ever actually paid? — is answered against the payment record, not the provider's portal.

03 It lines up the facts

Everything worth knowing is pulled out and organized, each fact with a pointer back to its page. Then the checks run, in plain terms: what holds up sits next to what doesn't. Here, the provider's portal contradicts the bank — the bill was paid on March 14 and still shows as open.

04 The output is a packet, not an answer

What comes out is a packet, not a chat answer. On top sit the documents the work produced: the case assessment, a follow-up plan with dates, a plain-language update for Maria, and every proposed send — fax to the billing office, email to the payer — as a checkable action. Underneath, the proof layer: a validation pass that lists anything wrong with the actions themselves (a missing contact, placeholder text, a bad page reference), an independent claim-by-claim verification with citations, and one reviewable page that ties it all together.

05 Nia brings it back to a person

Rosa works the case by talking to Nia — the assistant on every Grain task. Nia walks her through the violations list and the verifier's report; Rosa can approve the sends, ask Nia to rewrite a letter, or hand her a corrected EOB and have the affected work re-run from the last checkpoint, not from zero. When Rosa approves, her own systems execute the sends — Nia prepares the actions but never fires them herself.

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