Metrics question

A national health plan wants an agent that can answer questions like "What is my copay for a primary care visit?" and "How many physical therapy visits do I have left?" How would you define the MVP scope, fallback and escalation paths, and launch criteria when source data may be inconsistent and mistakes could erode trust? What metrics would you track in the first 90 days after launch?

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What this question tests

Tests MVP scoping and trust focused launch criteria for a benefits Q&A agent where inaccurate answers carry real financial and trust consequences.

How to approach it

  1. Scope the MVP to the highest confidence data sources first, for example clear copay amounts, deferring ambiguous benefit categories where source data is known to be inconsistent.
  2. Define a confidence threshold below which the agent must decline to answer and escalate to a human rather than guess.
  3. Design fallback language that is honest about uncertainty, for example directing the member to a phone line for edge cases, instead of a generic apology.
  4. Set launch criteria requiring a minimum accuracy rate on a held out sample of common questions, verified by human review against source plan documents.
  5. Track containment rate, accuracy rate against verified answers, escalation rate, and member complaint rate in the first 90 days.
  6. Review a sample of escalated and declined cases weekly early on to catch source data inconsistencies before they erode trust broadly.

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