Three Doors
Every 'no' arrives with its reason in plain language and three doors forward.
The job
Explain every adverse decision (rejection, refusal, fine, liability split) to the person it hit, in plain language with three concrete next steps, prove the explanation reduced anger, repeat calls and regulator escalations, and catch decisions that keep getting reversed on appeal.
The moment
A member stuck at a hospital reception taps Why?, reads the doctor's code doesn't match your plan; we've asked the hospital to resubmit, and 40 minutes later the same thread says Approved. At the weekly review, angry callbacks for that reason are down by two-thirds, complaints mentioning the regulator for it fell from 41 to 9, and Reversal Watch shows one reason reversed on 34% of appeals, which is now on the medical director's desk as a coding defect.
What it does
- Approve an explanation and its doors
- Publish the decision card
- Door: request resubmission
- Door: open an appeal with a clock
- Door: referral to an alternative
- Send a suspected defect to the decision owner
What you see
A customer-facing decision card with three action doors (customer help widget or WhatsApp) plus an internal explainer studio, reversal watch and regulator shield
What it moves
Repeat contacts and regulator-escalation mentions per rejection reason before vs after its explanation, door completion rate, and appeal reversal rate per reason
Built for
- Compliance, complaints & legal
- Contact-centre operations
