Payer-Facing AI Phone Calls

Payer-Facing AI Phone Calls includes products that enable AI-based interactions with payers over the phone. Generally, payer-facing companies will tend to be making outbound phone calls, but there may be some inbound-calling capabilities as well. Some of the common use cases for products in this category include:

  • Eligibility and verification of benefits

  • Prior authorization

  • Claims status checks

  • Denied claims appeals

  • Credentialing and provider management

Because the payer environment is generally much more controlled than a patient-facing environment, some of the differentiating factors in this space include:

  • Fallback support with human agents when the AI isn’t getting the job done

  • Technical considerations including data privacy, security, and EHR integration quality

  • Caller dashboard to enable requesting outbound calls and viewing call results.

  • Analytics capabilities to help track success rates and potential errors across calls.

  • Payer-specific modules to handle the IVR tree and agent script, or

  • Low-code script builder to enable customized calling procedures

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Amperos Health logo
Amperos Health
Claimed

Amperos Health

Company Info
Founded: 2023
Headcount: 1-10
Customers
Verified Customers: 4
Customers Served: Digital Health Provider, Ambulatory Practice, Hospital / Health System
Product Overview
Security and Compliance Certifications: HIPAA
Amperos Health is an AI agent for RCM-related outbound calling, focused on follow-ups for outstanding and denied claims. It calls insurance for claims status, investigates denied claims based on the reason for denial, and provides actionable steps to the RCM team to get paid faster.
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Bland AI
Claimed

Bland AI

Company Info
Founded: 2023
Headcount: 11-50
Customers
Verified Customers: 6
Customers Served: Digital Health Provider, Ambulatory Practice, Hospital / Health System, Life Sciences, Health Plan
Product Overview
Bland is an infrastructure solution to build AI phone agents for a variety of healthcare use cases, including cold calling for surveys, prior authorization, appointment scheduling, verification of benefits, and automated follow up to inbound inquiries. On the technical side, Bland have built their own LLM models for lower-latency conversations and higher reliability, and have the ability to break conversations into various sub-prompts to scale conversational complexity.
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Infinitus Systems, Inc.
Claimed

Infinitus

Company Info
Founded: 2019
Headcount: 51-200
Customers
Verified Customers: 2
Customers Served: Ambulatory Practice, Hospital / Health System, Health Plan, Life Sciences
Product Overview
Security and Compliance Certifications: SOC 2 Type 2, HIPAA
Infinitus provides an AI-driven platform designed to automate complex healthcare communications, particularly those traditionally conducted via manual phone calls. Their solutions include AI agents and copilots that handle tasks such as benefit verification, prior authorization, and prescription follow-ups by interacting directly with payors and pharmacy benefit managers (PBMs). This automation aims to reduce administrative burdens, enhance data accuracy, and expedite patient access to care.
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SuperDial
Claimed

SuperDial

Company Info
Founded: 2021
Headcount: 1-10
Customers
Verified Customers: 9
Customers Served: Digital Health Provider, Hospital / Health System
Product Overview
Security and Compliance Certifications: HIPAA
SuperDial is a platform for AI-enabled payer phone calls for insurance verification, prior authorization, credentialing and enrollment, and claim follow-ups. It offers a low-code UI for configuring call flows, placing calls, and viewing call results.
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Vogent
Claimed

Vogent

Company Info
Founded: 2020
Headcount: 11-50
Customers
Verified Customers: 2
Customers Served: Digital Health Provider, Hospital / Health System, Health Plan, Ambulatory Practice
Product Overview
Security and Compliance Certifications: SOC 2 Type 2, HIPAA
Vogent is an AI platform designed to automate phone calls in industries like healthcare, logistics, and travel. It uses low-latency, human-like voice interactions to handle tasks such as contacting payers, pharmacies, and clinics. Vogent's in-house language models can be fine-tuned with a few examples and integrate into existing workflows via API or a no-code dashboard. It supports features like IVR navigation, human handoff, and post-call automation.
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Clarion

Clarion

Company Info
Founded: 2023
Headcount: 1-10
Customers
Customers Served: Digital Health Provider, Ambulatory Practice
Product Overview
Security and Compliance Certifications: HIPAA
Anaphero provides AI-powered clinical assistants designed to support healthcare practices by automating tasks between patient visits. Its capabilities include continuous patient engagement, multilingual support, and empathetic interactions. For clinical operations, Anaphero automates patient registration, intake, referral management, social determinants of health screening, verification of benefits, pharmacy communications, and appointment reminders.
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Deepgram

Deepgram

Company Info
Founded: 2015
Headcount: 51-200
Customers
Customers Served: Ambulatory Practice, Hospital / Health System
Product Overview
Security and Compliance Certifications: SOC 2 Type 2, HIPAA
Deepgram is a voice AI platform offering APIs for speech-to-text, text-to-speech, and audio intelligence applications. It supports use cases such as medical transcription, contact center analytics, and conversational AI. The platform uses AI-based models to deliver high accuracy, real-time transcription, sentiment analysis, and intent detection. Deepgram’s solutions are designed to handle large-scale voice data, providing robust integration options and customization for various industries.
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Develop Health

Develop Health

Company Info
Founded: 2022
Headcount: 1-10
Customers
Verified Customers: 4
Customers Served: Digital Health Provider, Ambulatory Practice
Product Overview
Security and Compliance Certifications: HIPAA
Develop Health is an AI-enabled eligibility checking and prior authorization platform for medication. It automates benefit verification, clinical eligibility checks, and prior authorization form completion, and automatically calls payers to get benefit details. By integrating patient insurance data and clinical history, the platform increases first-time approval rates and reduces delays in accessing medications.
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Health Harbor

Health Harbor

Company Info
Headcount: 1-10
Customers
Verified Customers: 2
Customers Served: Digital Health Provider, Ambulatory Practice, Hospital / Health System
Product Overview
Security and Compliance Certifications: HIPAA
Health Harbor is an AI agent that calls insurance companies for eligibility and claim status checks.
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Majorboost

Majorboost

Company Info
Founded: 2020
Headcount: 1-10
Customers
Customers Served: Ambulatory Practice, Hospital / Health System
Product Overview
Security and Compliance Certifications: SOC 2 Type 1, HIPAA
Majorboost offers an AI-based outbound calling copilot for AR, Prior Authorization, Credentialing, Eligibility, and Patient Calls, with handling for phone trees, waiting on hold, and note-taking to augment in-office satff.
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Outbound AI

Outbound AI

Company Info
Founded: 2021
Headcount: 11-50
Customers
Customers Served: Ambulatory Practice
Product Overview
Security and Compliance Certifications: SOC 2 Type 2, HIPAA
Outbound AI offers AI-powered virtual agents for revenue cycle automation that handle tasks like claim status updates, benefits verification, prior authorizations, and managing denials. They can communicate with human representatives, take notes, generate summaries, and alert human workers when necessary.
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Standard Practice

Standard Practice

Company Info
Founded: 2021
Headcount: 1-10
Customers
Customers Served: Digital Health Provider, Ambulatory Practice
Product Overview
Security and Compliance Certifications: HIPAA
Standard Practice provides voice AI for outbound calls to payers and pharmacies for workflows like benefits verification, credentialing, prior authorization, and medication checks.
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Vapi

Vapi

Company Info
Founded: 2020
Headcount: 1-10
Customers
Customers Served: Digital Health Provider
Product Overview
Security and Compliance Certifications: HIPAA
Vapi is a platform for building and deploying AI phone agents for applications like booking appointments, delivering test results, and performing prior authorizations. It can integrate with EHR systems and internal APIs to retrieve data and perform actions during the call. It supports both inbound and outbound calls, and has a 500ms latency response time.