Truffl
Healthcare & TPA Operations
Handle document follow-ups, claims queries, and appointment reminders at scale — with built-in guardrails for healthcare contexts.
Use cases
Missing document flag in claims system
Call insured, explain missing docs, send WhatsApp upload link
Documents submitted, claim unblocked
Inbound query on claim status or pre-auth
Retrieve claim status, explain processing stage, escalate if needed
Query resolved or escalated to human agent
Appointment scheduled 24–48 hours out
Reminder call, collect confirmation or reschedule, send pre-visit instructions
Confirmed or rescheduled, no-show rate reduced
Policy renewal or lapse warning
Outbound follow-up call, explain renewal options, collect intent
Renewal initiated or intent captured
Confusion, anger, or out-of-scope query detected
Acknowledge, capture reason, warm transfer to human agent
Seamless handoff with full transcript
Workflow detail
Agent receives from TPA system
| Claim ID | CLM-2024-009812 |
| Insured name | Ravi Shankar |
| Admission date | 2024-03-15 |
| Missing documents | Discharge summary, original bills |
| Query amount | ₹1,45,000 |
| Reminder stage | Stage 2 of 3 |
Agent workflow
Agent receives claim ID, insured name, missing docs list, and query amount from the TPA system.
Agent explains in simple language (Hindi or English) which documents are required and why.
Agent confirms the insured understands what's needed and agrees to submit.
A secure document upload link is sent via WhatsApp during the call.
If confusion, anger, or complex queries detected — agent transfers to human with full transcript.
Safety & compliance
Truffl voice agents in healthcare deployments operate within strict boundaries to protect patients and stay compliant.
Agents never diagnose, prescribe, or interpret medical information.
Policy queries beyond scope are escalated to human agents.
Every call includes opt-out instructions. DND is respected on all channels.
Sentiment detection triggers immediate warm transfer to a human agent.
Patient names, claim IDs, and health data are never logged beyond the call transcript.
Built for healthcare and TPA teams that need scale without sacrificing patient experience.