Thousands more calls processed. Same team.
If you administer medical or pharmacy benefits, we run your inbound line: eligibility, claims status, formulary, and network search. Providers, members, and pharmacies get a correct answer on the first call, at one rate per call.
Which benefit do you administer?
The work is the same discipline either way. What changes is the benefit behind the call.
I administer medical benefits.
We run your inbound benefits line end to end. Providers and members reach a real answer on the first call, with the service levels, quality scoring, and compliance documentation your plan already expects.
- Claims status calls from providers
- Eligibility and benefits, either caller
- Health risk assessments by phone
- Provider search and referrals
- Outbound member outreach
I manage a pharmacy benefit.
We run your inbound pharmacy line end to end. Members and pharmacies reach a real answer on the first call, with the service levels, quality scoring, and compliance documentation your program already expects.
- Pharmacy claims from the counter
- Formulary and benefits, either caller
- Pharmacy search and referrals
- Adherence and refill outreach
Trusted by benefit administrators, healthcare providers, PBMs, and partners nationwide
One partner for your whole call line
We handle provider and member calls the way your own best team would, matched to how your organization actually runs.
Third-party administrators
Take overflow or your full inbound line, scaled to your book of business without adding headcount.
Health plans
Protect your CAHPS scores and service levels while cutting the cost of every routine call.
Carriers
Outsourced benefits call handling that scales up and down with enrollment cycles.
Provider calls
Claims status
Real-time claim status and payment details, resolved without a transfer.
Eligibility & benefits
Coverage, benefits, deductibles, and accumulator balances confirmed on the call.
Member calls
Eligibility & benefits
What is covered, what it costs, and why, explained clearly the first time.
Health risk assessments
Complete more HRAs by phone, lifting completion rates without a call center.
Provider search
Members find in-network care on the first call, with a texted shortlist.
One partner for your whole pharmacy line
We handle pharmacy and member calls the way your own best team would, matched to how your formularies actually run.
Full-service & standalone PBMs
Take overflow or your full inbound line, scaled to your book of business without adding headcount.
Health plans with an in-house benefit
Protect your CAHPS scores and service levels while cutting the cost of every routine pharmacy call.
Specialty pharmacy programs
Routing and referral for high-touch specialty therapies, with the right pharmacy found on the first call.
Pharmacy calls
Pharmacy claims
Reject codes, overrides, and resolution at the counter, without a transfer.
Formulary & benefits
Tier, quantity limits, and coverage confirmed live for prescribers.
Member calls
Formulary & benefits
What is covered, what it costs, and why, explained clearly the first time.
Pharmacy search
Members find an in-network or mail-order pharmacy on the first call.
Adherence & refill outreach
Outbound reminders that lift adherence without a call center of your own.
A managed service, not a tool to babysit
Whether we are answering your line or calling payers for you, we stand it up, connect to your systems, and run it with people watching quality every day.
Discovery & BAA
We scope your call types and sign the business associate agreement up front.
Integration
We connect to your admin or claims platform and define exactly how data flows.
Configuration
Scripts, escalation rules, and service levels tuned to your plan or your payer mix.
Live & measured
Calls handled around the clock, every one QA-scored and reported back.
Built for PHI from day one
Protected health information stays inside a controlled, audited environment, on the administrator side and the provider side alike. We hand your compliance team the documentation they need before the first call is ever answered.
Fewer holds, cleaner calls, lower cost
Call resolution
Answer speed
Onboarding
Quality coverage
TPAs already running on EHVAhealth
Acuity Group: 81% automated
Claims, eligibility, and benefits calls answered end to end for a TPA covering 16,471 lives.
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Benefits and claims calls answered from plan documents and EOBs, 24/7, measured on 4,324 calls.
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A per-call cost model for eligibility, benefits, and claims status calls, including the costs finance usually leaves out.
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Read the postSee what it costs to stop missing calls
No pitch. We will walk you through real call handling, on whichever side of the phone you are on.