Project Title: Healthcare AI Insurance Verification Agent

Alliance Orthopedics

Details
Project Title Healthcare AI Insurance Verification Agent
Project Topics Artificial Intelligence & Machine Learning Data Management Innovation Lean Systems and Process Improvement Operational Performance and Metrics Operations Research & Development Software Design & Development Strategic Planning UX/UI & Human-Centered Design
Skills & Expertise Data Collection Python
Project Synopsis: Challenge/Opportunity
Alliance Orthopedics is a leading health care, specialized orthopedics, that focusing on patient outcomes and satisfaction. 

However, as an out of network facility, we have to call insurance companies to find out what benefits each of our patients have.  Currently, the manual process of making these calls to insurance companies is labor intensive and prone to errors. This situation creates a pressing need to use AI to streamline this process. 

All components of this AI project will be designed, developed, and deployed only to the extent permitted by applicable laws and regulations. Any features or capabilities that are restricted or prohibited by law will be excluded or implemented with appropriate safeguards to ensure full legal and ethical compliance.
Project Synopsis: Activities/Actions Required
  • Build a voice-enabled AI agent to call insurers and collect data on eligibility, deductibles, co-pays, and authorization requirements.
  • Enable human QA (quality assurance) oversight and confidence scoring to flag unclear responses.
  • Include an autonomous phone-tree mapping feature that periodically tests insurer phone lines, detects changes in dial paths or phone numbers, and dynamically updates the AI agent’s call logic to avoid failure points.
 All components of this AI project will be designed, developed, and deployed only to the extent permitted by applicable laws and regulations. Any features or capabilities that are restricted or prohibited by law will be excluded or implemented with appropriate safeguards to ensure full legal and ethical compliance. 
Project Synopsis: Expected Results
A system that will do the following:
  • Make a phone call to an insurance carrier
  • Press the sequence of buttons needed for insurance verification. This sequence is stored somewhere that the system can access. However if the sequence of buttons does not work (this usually happens when the insurance companies change the button sequence), then the system should listen to the prompts to recalculate the sequence of buttons.
  • Ask the insurance carrier about different benefits that the patient has. The sequence of questions to ask will be provided as a resource in a playbook, as the questions can change depending on what services the patient would like to get.
  • Flag any unclear responses
  • Log the answers to the questions

 All components of this AI project will be designed, developed, and deployed only to the extent permitted by applicable laws and regulations. Any features or capabilities that are restricted or prohibited by law will be excluded or implemented with appropriate safeguards to ensure full legal and ethical compliance. 

Project Timeline

Alliance Orthopedics - Healthcare AI Insurance Verification Agent
Due Date
Activities
Deliverables
Status
Action
Tue, 01/20/26
12:00 AM UTC
Academic Calendar
We’ve linked the Academic Calendar for this semester (below) to help you stay on track. It includes key dates such as university holidays, class schedules, deadlines, and other important academic milestones.

Be sure to review it carefully so you’re aware of when your team meets, when assignments are due, and how your Capstone work fits into the broader semester. Staying organized starts here!

https://www.stevens.edu/office-of-the-registrar/academic-calendar
No Deliverables
No deliverables are required for this action item.
Guiding Questions:
We’ve linked the Academic Calendar for this semester (below) to help you stay on track. It includes key dates such as university holidays, class schedules, deadlines, and other important academic milestones.

Be sure to review it carefully so you’re aware of when your team meets, when assignments are due, and how your Capstone work fits into the broader semester. Staying organized starts here!

https://www.stevens.edu/office-of-the-registrar/academic-calendar
Fri, 04/10/26
11:59 PM EST (UTC-05:00)
Spring 2026 Midterm Student Evaluation
Required Evaluation
Evaluation submission is required.
Fri, 04/10/26
11:59 PM EST (UTC-05:00)
Spring 2026 Midterm Presentations
Required Action Item
The Midterm Presentation is a key milestone in your Capstone experience. It gives your team the opportunity to showcase your progress, clarify your project goals, and gather valuable feedback from your faculty advisor and School of Business staff. 

This is your chance to demonstrate your understanding of the challenge, the approach you’re taking, and any early insights you've uncovered. Clear communication and thoughtful analysis at this stage will help ensure a strong finish to your project in the second half of the semester.

Treat it as both a checkpoint and a strategic opportunity to refine your work moving forward!

Christina Alwell will coordinate with team leads in February to schedule the midterm presentations. These will take place in mid-March.

Team Leads: Please upload a copy of your team’s Midterm Presentation here. This submission helps us keep track of progress and ensure faculty and industry partners have access to your work.
Required Deliverable
Deliverable submission is required.
Guiding Questions:
The Midterm Presentation is a key milestone in your Capstone experience. It gives your team the opportunity to showcase your progress, clarify your project goals, and gather valuable feedback from your faculty advisor and School of Business staff. 

This is your chance to demonstrate your understanding of the challenge, the approach you’re taking, and any early insights you've uncovered. Clear communication and thoughtful analysis at this stage will help ensure a strong finish to your project in the second half of the semester.

Treat it as both a checkpoint and a strategic opportunity to refine your work moving forward!

Christina Alwell will coordinate with team leads in February to schedule the midterm presentations. These will take place in mid-March.

Team Leads: Please upload a copy of your team’s Midterm Presentation here. This submission helps us keep track of progress and ensure faculty and industry partners have access to your work.
Fri, 05/22/26
11:59 PM EST (UTC-05:00)
Spring 2026 Final Student Self Reflection
Required Evaluation
Evaluation submission is required.
Fri, 05/22/26
11:59 PM EST (UTC-05:00)
Spring 2026 Final Presentations
Required Action Item
The Final Presentation is the culmination of your semester-long work and a chance to demonstrate the impact of your project. This is where your team presents your findings, recommendations, and overall contributions to your industry sponsor and faculty advisor.

It’s not just about what you accomplished—it’s about how you approached the problem, collaborated as a team, and applied your skills to deliver meaningful outcomes. Think of it as your professional showcase: a polished, confident presentation that reflects your effort, growth, and real-world readiness.

Take pride in what you've built and finish strong!

Christina Alwell will coordinate with team leads in early April to schedule the final presentations. These will take place in early/mid May (last week of classes and/or final exam period).

Team Leads: Please upload a copy of your team’s Final Presentation here. This submission helps us keep track of progress and ensure faculty and industry partners have access to your work.
Required Deliverable
Deliverable submission is required.
Guiding Questions:
The Final Presentation is the culmination of your semester-long work and a chance to demonstrate the impact of your project. This is where your team presents your findings, recommendations, and overall contributions to your industry sponsor and faculty advisor.

It’s not just about what you accomplished—it’s about how you approached the problem, collaborated as a team, and applied your skills to deliver meaningful outcomes. Think of it as your professional showcase: a polished, confident presentation that reflects your effort, growth, and real-world readiness.

Take pride in what you've built and finish strong!

Christina Alwell will coordinate with team leads in early April to schedule the final presentations. These will take place in early/mid May (last week of classes and/or final exam period).

Team Leads: Please upload a copy of your team’s Final Presentation here. This submission helps us keep track of progress and ensure faculty and industry partners have access to your work.