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UBCHub Services · Executive Brief
Prepared for Nicole Hebbert · Director, Patient Access
The patient

Meet Sarah Whitman.

“I was told my medication needed approval. I didn’t know what that meant, or how long I’d wait.”

47 · Generalized myasthenia gravis · Prescribed VYVGART · BCBS Pennsylvania
18min
Call, start to finish
1call
Not 3–5 days on hold
0PHI
Retained after the call

Anatomy of the call

Total time · 18 minutes
SA
Sarah AI
Enrollment received from Dr. Adams
“New VYVGART patient — I'll take it from here.”
9:14 AM
9:16 AM
SW
Patient
Sarah calls Sarah Whitman
“Yes, this is a good time. My card is BCBS Pennsylvania.”
SA
Sarah AI
Insurance verified in real time
“Plan active. Deductible $3,500. PA required.”
9:19 AM
9:22 AM
SA
Sarah AI
Calls BCBS, navigates the phone tree
“Provider line, prior authorization, specialty medications.”
BC
Payer Rep
Sarah answers every PA question
“Diagnosis, labs, prior therapy — all confirmed.”
9:29 AM
9:32 AM
BC
Payer Rep
VYVGART approved · logged to D365
“Authorization approved. Valid six months.”
Sarah AI
Patient
Payer Rep

Before, and now.

Before
5 days
  • ✗3–5 days on hold with payers
  • ✗Coordinators tied up on phone trees
  • ✗Manual PA paperwork, faxed and re-faxed
  • ✗Patients waiting weeks to start therapy
With Sarah
18 min
  • ✓One clean call, start to finish
  • ✓Coordinators freed for complex cases
  • ✓Every action logged, PA auto-submitted
  • ✓Patients start therapy the same week

When the call goes off-script.

Off-topic question“Order me a pizza pie.”
Sarah politely redirects to benefits. Never guesses, never hallucinates.
Medical emergency“I'm having chest pain.”
Immediate warm transfer to a live agent. 911 script read. Flagged in audit log.
Repeated derailment“Three off-topic attempts in a row.”
Warm handoff to a human coordinator with full call context.
21 CFR Part 11·HIPAA · BAA-ready·Zero PHI retained·Every call fully audited, every action timestampedPowered by SJ Innovation

One page. One patient. Hand it to Nicole and she’ll know exactly what Sarah does — and what happens when a call goes sideways.

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