AI Call Management
Routine AI-assisted member and provider inquiries and the circumstances that warrant human support.
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HEALTHCARE PAYERS
Agent time belongs with the inquiries that need it.
RealCall identifies synthetic speech on member and provider lines. Eligible AI inquiries can stay in self-service under your service policy, protecting agent capacity for complex requests while preserving verification for sensitive information.
An authorized assistant asks a routine provider-line question
An assistant asks for information on a provider line. Access permissions and the requested details determine whether the inquiry is eligible for automated handling. RealCall contributes the synthetic-speech signal; your platform owns the handoff.
Sources: One anonymous insurer; agent-time exposure, not cash savings. 2025 CAQH Index, published 2026; national administrative estimates.
$5M+
annual agent-time cost exposure avoided at one insurer.
$21B
potential annual administrative savings from full transaction automation.
50%+
of health plans used AI in administrative workflows.
Agent capacity, queue pressure, and service access
Agent capacity
Eligible routine inquiries can remain in self-service, leaving agents available for requests that need human attention.
Legitimate service
Authorized assistants can receive routine information within their permissions, while sensitive requests follow the required verification.
Sensitive-request control
Your platform combines permissions, request details and the speech assessment when choosing automation, further verification or an agent, including an agreed fallback for uncertain cases.
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PRODUCTS
RealCall for member and provider lines
See RealCall on a member or provider line.
Discuss your setup\
PRACTICAL GUIDANCE
A service path for authorized assistants
The contact-center guide examines automated handling for legitimate AI inquiries, with a human path for sensitive requests.
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RESEARCH + INSIGHTS
Research and practical guidance
Rethink the handoff on your provider line
The walkthrough follows one inquiry from IVR entry to automated handling, further verification or a member of your team.