AI for Eligibility and Benefits Verification Calls

CuraVoice calls the payer to verify eligibility and benefits, handles the menu and the hold, and connects your staff member when a representative is on the line.

The problem

Electronic eligibility checks return coverage dates and little else. For services with complicated benefits, staff still phone the payer to confirm what is covered, what the patient owes and whether authorization is needed. Those calls are long and mostly waiting.

How the call runs

Your list of patients to verify is uploaded as a CSV file.
The agent dials the payer's eligibility and benefits line.
It enters NPI, tax ID, member ID and date of birth when asked.
When a representative answers, your staff member joins to ask the benefit questions.

What your staff do

Benefit questions are specific to the service, so a person asks them. The agent removes the part of the call that needs no expertise.

Getting started

The agent works from a CSV export of your work queue, so no integration is needed to begin. Every call is recorded and logged with its outcome. See how payer calling works.

Common questions

Which services need phone verification?

Typically those where the electronic response is too thin: infusions, specialty drugs, durable medical equipment, therapy visit limits and out-of-network benefits.

Does the AI speak to the payer representative?

By default, no. When a live representative answers, your staff member is warm-transferred into the call to have the conversation.

Run it against your top payers

Tell us which payers your team calls most and we will show you a call from dial to hand-off.

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