AI Self-Funded Plan Performance Dashboard Agent

How Cassidy automates this using AI

Step 1: Trigger on data feed arrival

The Workflow activates when new claims, eligibility, or vendor files land via SFTP or API whether daily deltas or monthly extracts from your TPA, PBM, or care management partners.

Step 2: Normalize and validate incoming data

Cassidy maps fields to your common data model, standardizes codes (ICD, CPT, NDC), resolves provider identities, and runs QA checks for eligibility gaps, duplicate lines, and missing values flagging anomalies for review.

Step 3: Calculate derived metrics and benchmarks

The Workflow computes member-months, PMPM/PEPM, utilization rates, risk scores, and large claimant flags, then compares against internal baselines and external benchmarks to identify variance drivers.

Step 4: Detect waste and surface opportunities

Cassidy applies rules-based edits and anomaly detection to flag suspect claims duplicate billing, upcoding, site-of-care inflation, formulary exceptions and routes findings to your issues log with audit-ready documentation.

Step 5: Generate executive report packs

The Workflow auto-builds CFO/HR decks with KPIs, trend charts, forecast-to-year-end, high-cost claimant summaries, and recommended actions distributing them on schedule with role-based access controls.

Step 6: Score vendors and attribute ROI

Cassidy tracks program cohorts, runs pre/post analysis against matched controls, and produces vendor scorecards showing net savings after PEPM fees giving you defensible ROI proof for every point solution.