Scope Gaps We Close

13 · Coverage

Scope Gaps We Close

Generic contact-center AI leaves dangerous holes for benefits operations. This deck explicitly closes them.

Close the holes

Subprocessor BAAs

Material vendors under agreement.

Member auth before PHI

No casual PHI leakage in chat/voice.

PCI for payments

Payment-method changes stay compliant.

Insurance advice limits

Hard refusals + handoff rules.

TCPA / DNC

Outbound consent and suppression.

Recording consent

Prompts + retention policy.

OE concurrency

Burst capacity playbooks.

Human workforce model

Your specialists, AI deflection.

Knowledge governance

Owners, versions, publish gates.

Carrier escalations

Structured paths when carriers must act.