Billing Support Scoping
Two weeks of scoping with the billing team: the support transcripts, the refund and cancellation policies, and every system a specialist uses.
Findings
- 01Long Waits
Calls averaged more than an hour in the queue.
- 02After Hours
A quarter of calls came in after hours. None of them were answered.
- 03Policy Gaps
Two refund policies contradicted each other.
PII-masked records from the client's QA platform tagged by intent, resolution pattern, and escalation reason.
Refund eligibility, pause and cancellation rules, pricing tiers, and escalation thresholds. We found two policies that contradicted each other and flagged them.
Every system a specialist opens to resolve an inquiry with the APIs an agent can call and the gaps that need engineering work.
Inquiry Mix
- Billing, refunds & cancellations40%Dual charges cause the most confusion
- Prescriptions & order status20%Answered from shipment data
- General & program questions18%Knowledge-base answers are next on the roadmap
- Appointments & scheduling12%Waiting on internal APIs, handled as tasks for now
- Everything else10%Misroutes, one-offs, edge cases
Share of inbound volume by intent from the transcripts and disposition data.
The Systems Map
HoverTap a system to see what the agent does with it.
Stello agentConnects to 8 systems live, 1 used in scoping.
Billing and Payments
- Subscription billing platformRevenueAgent reads.Holds memberships, renewals, and invoices. The agent reads it to explain a charge or a renewal date.
- Payment processorRevenueAgent reads.Runs the card payments. The agent reads charge history here to spot dual charges before a refund review.
Patient Record
- Proprietary CRMPatient dataReads and writes.The client's own patient record system. The agent verifies identity here and writes the disposition and staff note.
- EHRClinicalAgent reads.The electronic health record, or clinical chart. The agent reads it only to confirm a patient's prescription status.
- Patient portalSelf-serviceAgent reads.Where patients manage their account themselves. The agent points callers to it for tasks they can do alone.
Support Team
- Support platformServiceAgent writes.The helpdesk the billing team works from. Refunds and disputes land here as tasks with full context.
- QA platformQuality · Used in scopingUsed in scoping, not connected live.Where call recordings and transcripts are reviewed. Scoping started from these transcripts.
- Analytics dashboardsReportingAgent writes.Reporting on volume and outcomes. Auto-resolution is tracked here week by week.
Knowledge
- Vector knowledge baseRetrievalAgent reads.A searchable index of the client's policies and help articles. The agent answers general questions from it.
System names are generic here for confidentiality. The real deliverable names each one with its owner and endpoints.