Artera AI Agents are autonomous agents that hold dynamic conversations with patients. This article walks through what a patient experiences when they call to request a prescription refill or renewal and reach an AI agent.

NOTE: This article describes how the Prescription Refill AI Agent works in general. Your organization's specific setup, including which requests your patients can make and which rules apply, is configured with your AI Service Squad. Your AI Service Squad or Customer Success Representative can confirm your configuration.

What This AI Agent Handles

This AI agent handles prescription refills, renewals, and change requests on inbound voice calls. It pulls the patient's current medication list from your EHR and, when a request needs provider review, creates the record directly in your EHR so it shows up in your workflow.

Each request type follows a different path:

• Refill: The patient calls to ask for more of a medication they already take and refills remain on their prescription. The AI agent directs the patient to their pharmacy.

• Renewal: The patient calls to ask for more of a medication they already take, but no refills remain. The prescription needs provider authorization, so the AI agent creates a request in your EHR for provider review.

• Change request: The patient calls to request a different dose or wants the prescription filled at a different pharmacy. The AI agent captures the change and files it in the EHR for provider review.

• Off-list medication: The patient calls to ask for a medication that is not on their current list. The AI agent captures the request and flags it in the EHR so a staff member sees it. Based on your desired flow, the AI agent can also direct the patient to schedule a new appointment for this request.

NOTE: The AI agent does not send outbound refill reminders and does not handle refill requests by text. If your organization sends prescription-related outbound messages, those are separate workflows. Your AI Service Squad can confirm what is in scope for your organization.

What Happens to Each Request

Refill Resolved at the Pharmacy

Refills remain on the patient’s prescription, so the request does not need a provider. The AI agent tells the patient to pick the prescription up at their pharmacy, confirms the pharmacy on file, and ends the call. No record is created in the EHR and no one on your staff encounters the request. 

Renewal Routed for Provider Authorization

No refills remain, so the request needs provider authorization. The AI agent confirms the medication and dosage with the patient, applies your eligibility rules, and writes a renewal request to your EHR. 

The request is classified as a refill request, left open for review, and assigned to the provider or the staff member who handles that provider's refills. The note carries the medication, the dosage, and the patient's pharmacy.

The AI agent tells the patient that the request has been submitted to their provider and that the prescription will be filled at their pharmacy once it is approved.

NOTE: The AI agent does not tell a patient that a prescription has been approved or that it is ready at their pharmacy. It confirms only that the request was submitted for review.

Change Request: Dose, Pharmacy, or Off-List Medication

The patient requests a different dose, wants the prescription filled somewhere else, or asks for a medication that is not on their list. The AI agent recognizes that the request is a change rather than a repeat, captures what changed, and files it as its own request in the EHR for provider review. Requests for medications that are not on the patient's list are filed the same way and flagged explicitly. 

At a Glance

How Patients Reach the AI Agent

Patients reach this AI agent by calling a phone number your organization owns or one Artera provides. Your organization chooses one of two setups during implementation:

• Through your existing phone number: The AI agent sits inside your phone tree. For example, callers who choose the prescriptions or refills option are routed to the AI agent.

• Through a dedicated Artera line: Patients call a number configured specifically for your AI agent and connect without going through your main phone tree.

Inbound Conversations: What the Patient Experiences

1. The patient calls your organization. The AI agent answers and asks how it can help.

2. The AI agent confirms the patient's identity before it discusses any medication. It asks for the fields your organization configured, commonly first name, last name, date of birth, and ZIP code.

3. The AI agent checks the patient against your eligibility rules, such as a recent-visit requirement or whether the patient's provider participates in the workflow. Patients who are not eligible are given the appropriate next step.

4. The AI agent reads back the patient's current medication list from their chart in the EHR, so the patient can choose the right prescription.

5. The patient chooses a medication and confirms the dosage.

6. The AI agent confirms the pharmacy on file.

7. The AI agent checks whether refills remain on the prescription and takes the appropriate next step. If refills remain, it directs the patient to their pharmacy. If none remain, it creates a renewal request in your EHR for provider review.

8. The AI agent explains to the patient what happened and what comes next before the call ends.

The AI agent transfers the call to your staff when:

• Identity verification fails.

• The request needs clinical judgment.

• The patient asks about something outside the AI agent's scope.

NOTE: When the AI agent transfers a call, the conversation context is saved to that patient’s Patient Channel in Artera. Your staff can see what the patient already discussed with the AI agent, so the patient does not have to repeat themselves.

How the AI Agent Applies Your Eligibility Rules

The AI agent works from the rules your organization already follows for refills and can be further refined alongside your AI Service Squad. These rules commonly include:

• Recent visit requirement: Whether the patient must be seen within a set period before the AI agent can take the request.

• Provider participation: Which providers are enrolled in the AI agent workflow. Requests for providers who are not enrolled follow your fallback path.

• Medications in scope: Which medications the AI agent is allowed to handle.

• Next step when a patient is not eligible: What the AI agent tells the patient and where it sends them.

What Varies by Configuration

This AI agent is built around each organization's refill workflows, so the details below differ between organizations. Your AI Service Squad or Customer Success Representative can confirm them for your organization:

FAQs

Does the AI agent decide whether a patient gets their medication?

No. The AI agent checks whether refills remain on the prescription. If they do, it directs the patient to their pharmacy. If refills do not remain, it submits the request to the patient's provider for review. Only the provider authorizes a renewal.

Does the AI agent handle prescriptions that still have refills remaining or only ones that need renewal?

Both. Requests with refills remaining are resolved at the pharmacy and requests without them are routed for provider authorization.

Does a renewal request need manual cleanup in the EHR?

No. The AI agent writes the request directly into your EHR as the correct record type, classified and assigned, with the medication, dosage, and pharmacy included.

Can the AI agent handle a dose change?

Yes. The AI agent recognizes a dose change as a change request rather than a repeat refill, captures what changed, and files it in the EHR for provider review.

What happens if the patient asks for a medication that is not on their list?

The AI agent captures the request and flags it for staff review, so the request is not lost.

Does the AI agent tell the patient which pharmacy the prescription is going to?

The AI agent confirms the pharmacy on file with the patient during the call. It does not tell the patient that a prescription is ready or waiting at that pharmacy.

Does the AI agent support languages other than English?

Yes. AI agents can hold these conversations in various languages. Which languages are enabled is part of your configuration. For a full list of supported voice languages, click here.

What happens if the AI agent cannot verify the patient?

The AI agent transfers the call to your staff.

Can the AI agent answer a clinical question about a medication?

No. The AI agent does not give medical advice. It transfers clinical questions to your staff with the conversation context available in the Patient Channel within Artera.

Is the AI agent available after hours?

Yes. The AI agent answers refill and renewal calls around the clock. What happens to requests that need staff involvement outside your staffed hours is part of your configuration.