Member Lookup Flow

Sequence

graph LR A["search_members
(no session)"] -->|"masked results"| B["verify_member
(creates session)"] B -->|"session + profile"| C["get_member_profile
(full details)"] style A fill:#ed8936,color:#fff style B fill:#48bb78,color:#fff style C fill:#4299e1,color:#fff

Step-by-Step

Step 1: search_members (Pre-verification)

Search for members when you don’t have a Medicaid ID. No session required.

Input: at least one of name, dob, phone
Output: candidates[] with masked PII (masked DOB: **/**/YYYY, masked phone: ***-***-XXXX)
Returns member_id (Medicaid ID) for use in verify_member

Step 2: verify_member

Verify the member’s identity using the Medicaid ID from search results.

Input: member_id from search_members, plus name and dob for verification
Output: session_id, flat response with home_address, treatment_types, service_types, mobility_type, mr_enrolled

Step 3: get_member_profile (Optional)

Retrieve the full member profile within the active session. Returns the detailed MemberDossier as profile.

Input: session_id
Output: profile with personal, medical, benefits, history, and recent_addresses sections

When to Use Each Tool

Scenario	Tool
Agent does not have Medicaid ID	Start with `search_members`
Agent has Medicaid ID	Start with `verify_member` directly
Need fresh profile data mid-session	Call `get_member_profile`

MemberDossier Sections

The profile returned by get_member_profile includes:

personal: member_id, medicaid_id, name, DOB, phone, home address
medical: mobility_type, required_vehicle_type, special_needs
benefits: eligibility_status, plan_name, trip limits (yearly limit/used/remaining), MR/VD enrollment
history: recent_trips, frequent_destinations, preferred_transport_mode
recent_addresses: labeled addresses (Home, etc.)