AI Assist on calls for Health Payers. Plan answers on screen while your representative talks.
AI Assist on calls shows your representative suggestions from your knowledge during a live member or provider call: the timely-filing rule from the provider manual, the employer's plan design for a TPA member, the steps to file an appeal. The member or provider office only ever hears your representative, who decides what to say.
TRY AI ASSIST FREENo credit card · Ready in 2 minutes7 days free · per company, never per seat · nothing to install
You talk. Lisa sets it up.
You“During provider calls, suggest answers from the provider manual and timely-filing rules.”
Lisa“Done: during provider calls, representatives see suggestions from the provider manual and your timely-filing rules. Add the member plan summaries too?”
Any setting, in any module · applied only on your yes
How Health Payers use it
A member asks how to file a grievance; the screen shows the approved steps and the filing window while the representative explains.
A billing company asks about corrected claims; the representative sees the submission rule from your provider manual without a hold.
A TPA representative takes a call for a self-funded employer and sees that employer's copay schedule as soon as the member names the plan.
REAL AI - the whole Front Office is AI, not old software with an AI button.
What’s included
- Live suggestions from your knowledge during a call, on your operator's screen
- Never speaks to the customer, your person stays the voice
Add it to AI Call Desk or get it inside a solution · See pricing › · Per company, never per seat.
Everything AI Assist on calls does, for every business ›
Works withAI Call DeskAI PhoneAI TicketsAI QuotingAI Booking
Questions & answers
AI Assist on calls for Health Payers: questions & answers
Does AI Assist talk to members during the call?
No. It only shows suggestions on the representative's screen, and the representative stays the voice. The member hears a person from the start of the call to the end.
Where do AI Assist suggestions for representatives come from?
From the knowledge you approve, such as plan documents, the provider manual, procedures and scripts. It never suggests a coverage determination; it surfaces the documented rule for the representative to use.
Do we need AI Call Desk for AI Assist?
Yes. AI Assist works on calls handled through AI Call Desk, the browser phone your member-services and provider-services representatives use every day.
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Where next?
Start with the one thing you need. Add more anytime by asking Lisa.
AI Front Office for Health Payers ›
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Winner at CES 2026, ISE 2026 and TMCnet Enterprise AI Product of the Year.
REAL AI - the whole Front Office is AI, not old software with an AI button.
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