Commercial Lines Service · Agent blueprint · validated with 8 team members

Billing Question Triage and Draft Agent

Reads an incoming billing question in Outlook, pulls the account and installment details from Applied Epic, and drafts a reply. Where Epic doesn't answer, a browser agent looks up the carrier portal billing record. A person reviews and sends every reply and requests any refund or correction.

61readiness · AI assist (a person acts)

2–4 hback per week, of 12 h now

$4K–8Ka year

4–7 wkto build · size M

Trigger

A client email about an invoice, double charge or past-due notice arrives in the team's Outlook mailbox (channel assumed to be email; to be confirmed).

Done when: The client knows what they owe, and any refund or correction has been requested from the carrier; the activity is logged in Applied Epic.

Needs: Client email (sender, question, any invoice or policy number); Applied Epic account, policy, carrier and billing/installment details; Carrier on the policy (Liberty Mutual, The Hartford, Travelers); Carrier portal billing record for the invoice or policy number (when needed); Team billing knowledge base (KB)

What the agent does

1
Detect new billing email and capture sender and message text · Outlookconnector
Power Automate trigger on the shared mailbox; filter with AI classification to separate billing questions from other requests.
2
Extract client, invoice number, policy number and question type from the email · Outlookai
Question types: invoice explanation, double charge, past-due notice. Flag missing identifiers.
3
Find the client account and read policy, carrier and installment details · Applied Epicapi
Match on client name, policy or invoice number; return the carrier and billing records.
4
Decide whether Epic answers the question or the carrier record is needed · Applied Epicai
Rule is unclear from the team; start by sending any case where Epic shows no clear answer or a possible duplicate to the portal lookup.
5
Look up the carrier billing record using the invoice or policy number from Epic · Carrier agent portalsui automation
Portals have no API (ui only). Browser agent works the Billing Center screens for Liberty Mutual, The Hartford or Travelers, read-only.
6
Compare Epic and carrier records and note any double charge or discrepancy · Applied Epicai
Summarize what each system shows; do not decide whose error it is.
7
Draft reply stating what was found in both systems and next steps · Outlookai
Save as a draft only. No coverage advice; flag anything that needs licensed staff.
8
Review findings, edit the draft and approve sending · Outlookperson
Account manager checks the draft and portal findings, and sends the reply.
9
If a double charge or error is confirmed, request refund or correction from the carrier · Carrier agent portalsperson
Person decides and makes the request; method (portal, email or call) not yet defined.
10
Log the request and reply as an activity on the account · Applied Epicapi
Required for every client request. Runs after the person approves; the agent fills in the summary.

Decisions the agent makes

Decide	Rule	Source
Whether a carrier portal visit is needed	Open the carrier's agent portal when Applied Epic does not give the answer. The team gave no more precise trigger; the carrier on the policy picks which portal.	The team
Which carrier portal to open	The carrier on the policy in Applied Epic (Liberty Mutual, The Hartford or Travelers).	Team, confirmed by data
Where to look first for carrier billing details	Team is split: Applied Epic first (43%), call or email the carrier (29%), or carrier portal (28%). Agent starts in Epic, and the team must confirm this.	The team
Whether a refund or correction is needed	If the review shows a double charge or error, request a refund or correction from the carrier before closing. What counts as an error and how to request it is unclear.	The team
How urgent leadership requests are handled	Not known yet: ask the team	Not known yet
Reply wording and structure	A reply stating what was found in both systems and what happens next. No fixed template exists.	The team

Where a person signs off

Account manager approves and sends every client reply (the agent never sends unattended).
Account manager decides whether a refund or correction is needed and requests it from the carrier.
Account manager approves the activity log entry before it is written to Applied Epic.

Exceptions

When	What the agent does
Epic gives the answer without a portal visit (about 60% of cases involve no portal; exact trigger unclear)	Skip the portal lookup and draft from Epic data alone, noting the source.
Carrier portal lookup needed (about 36–40% of cases, split roughly Liberty Mutual 40%, The Hartford 36%, Travelers 28%)	Browser agent retrieves the billing record by invoice or policy number; on any failure, hand to a person with what Epic showed.
Portal screen doesn't match what the agent expects, login fails or MFA prompts	Stop, hand the case to a person with the Epic findings and a link to the email.
Invoice or policy number missing or no matching account in Epic	Draft a request for the missing detail for the person to review; don't guess.
Urgent request from leadership (sometimes to often; handling not described)	Not known. Until the team defines it, flag the case for a person and don't change the queue order.
Question involves coverage advice or who made the error	Hand to licensed staff or the account manager; the agent only summarizes the facts.

Build with

Power Automate: Mailbox trigger, orchestration, calls to Epic API, approval and logging flow
Microsoft 365 Copilot / Copilot Studio: Classify the email, extract identifiers, compare records, draft the reply
Outlook connector: Read the incoming email and save the draft reply
Applied Epic API: Account, policy and billing lookup; activity logging
Power Automate Desktop / browser agent: Read-only lookup of carrier portal billing screens

Skills: Power Automate, Copilot Studio, Applied Epic API, Browser or UI automation, Insurance billing process knowledge

Before building

Applied Epic API access and a service account with read access to accounts and billing, and write access to activities
Shared mailbox access and Outlook connector
Microsoft 365 Copilot and Power Automate licenses (already held)
Dedicated sign-in for the browser agent on each carrier portal, with multi-factor handled
Check each carrier portal owner's terms on automated access (Liberty Mutual, The Hartford, Travelers)
Copy of the team KB for billing questions, and sample reply wording from the team

Risks

Carrier portal screens change without notice; monitor runs and hand to a person when a screen doesn't match.
Portal terms or MFA may restrict automated access, which would force the lookup back to a person.
The draft could misstate whose error it is or imply coverage advice; mitigated by person review and wording limits.
KB contents unknown, so the drafts may miss approval or refund rules.
Only 15–30% time saved is expected, since checking and judgment stay with a person.

How we'll know it worked

Median work time per billing question (baseline 4.5 min across 147 cases a week)
Team hours a week on billing questions (baseline 12.4)
Share of replies sent with minimal edits to the draft
Share of cases where Epic data was retyped into a portal (baseline 42–55% per transfer)

Still to answer before building

Which channel do billing questions arrive through: email, phone or something else?
Exactly which cases need a carrier portal visit, and what is looked up there?
What is the exceptional handling for urgent leadership requests?
What does the team KB say about approvals, checks and who may request refunds or corrections?
How is a refund or correction requested from the carrier (portal, email or call)?
Are there other cases that don't fit the usual handling besides leadership urgency?
Do the carrier portals permit automated access under their terms, and can a dedicated agent sign-in be set up?

Where the team disagrees

Settle these first: an agent needs one rule, and new hires get mixed answers today.

Where people look first for carrier billing details is split: Applied Epic (43%), calling or emailing the carrier (29%), or a carrier portal (28% combined).
How often unusual cases come up is split evenly between 'sometimes' and 'often'.

Evidence

35% of cases follow the same steps (some skip a step)
12 team hours a week
data is moved by hand from Applied Epic to Liberty Mutual Agent Portal (45% retyped)
3% of cases redo steps
36% of cases need an extra lookup (an exception the agent must handle)

Observed main path (29% of cases): Microsoft Outlook → Account · Accounting (Applied Epic) → Billing Center (Liberty Mutual Agent Portal) → Microsoft Outlook → Edit Message body

Handover spec for the builder (text) →

Designed by AI from how the team did this work (2026-10-19 to 2026-10-23), the company's tools and its rules. A starting point for the builder: confirm system access and approvals before building.