Winner CES 2026 · ISE 2026 · TMCnet 2026

AI Phone for Health Payers. Payer call center AI on your own member line

AI Phone is payer call center AI that answers your member and provider lines on the plan's own number, day and night, in each caller's language. It answers only from your plan documents and the answers your team approved, routes every call by its reason, and writes each one down with a transcript and a summary.

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7 days free · per company, never per seat · nothing to install

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Zanus AI · AI Phone · Today

Payer call center AI: every call of the day with who called, who handled it, how long and how it ended, real Zanus AI screen

Today

Today's member and provider calls in one list: the caller, the AI or representative who took the call, its length and its outcome, each answered at the first ring.

Easy setupSet up everything just by talking to Lisa AISee how ›

You“Appeals, eligibility and claim status go to a person; answer the rest from our documents.”

Lisa“I'm sending appeals, eligibility and claim status questions to your teams and answering the rest from your documents. Apply?”

You talk. Lisa sets it up. Applied only on your yes.

How Health Payers use it

A member calls on January 2 because her new ID card has not come; the AI files the request and tells her when to expect a reply.

A billing service asks where corrected claims go; the AI reads the address and the filing window from your provider manual.

A member disputes a denied claim; the AI tells the appeals team who is calling and why before the call connects.

REAL AI - the whole Front Office is AI, not old software with an AI button.

What’s included

Keep your number: forward your existing line to your Front Office line and the AI answers immediately, no porting needed. Port the number in when you decide; we handle it with the carrier
A local number in your area, or your own number ported in
Answers on the first ring, 24/7, 365; your business hours only decide when people are reachable
Human-like voice: you choose the voice and the persona per function, greeting, sales, support, booking, callbacks
Receptionist style, no phone menu: the caller just talks in any of 40 languages; the AI detects the language on the first sentence and switches the whole call
Departments you define, sales, support, booking, billing, technical…, each with its own policy: AI first, operator first, or AI only; each with its own AI specialist when no human is free
Directory of your operators with per-day working hours, languages, the nicknames callers use, vacations and temp-worker expiry
Transfers announce the caller and the reason; your person accepts before the call is connected; the call is pulled back before a mobile voicemail can swallow it
Language routing: a Spanish-speaking caller reaches your Spanish-speaking operator first
Hold music with spoken updates; when a person is unavailable the AI says the honest line you wrote for that time of day
Takes messages with the callback number read back and confirmed, delivered to that person's own inbox
Books appointments live from your calendar during the call; captures the e-mail letter by letter; saves the lead
Every fact from your approved knowledge, prices only from your catalog; with no source it says so and offers a person
Robocalls and telemarketers get one polite goodbye and stay away from your team
Off hours your way: full AI service, take-a-message only, or voicemail; holidays and special closures with the message you write
Every call transcribed into the customer's record with a summary; call log with transcripts, exportable; the morning briefing reads it for you

Available on its own or inside a solution · See pricing › · Per company, never per seat.

Everything AI Phone does, for every business ›

Works withAI Booking AI Calls Teleprompter AI Calls Transcripts AI Quoting AI Tickets AI Returns & Warranty AI CRM Lisa, your AI assistant

The member line

What payer call center AI answers on the member line

Most member customer service calls ask something your plan documents already answer. The AI answers those at once and files what needs your team.

Benefit terms explained

Deductible, copay, coinsurance and out-of-pocket maximum explained in plain words from your summaries, without saying what the member owes.

Lost cards and new addresses

A lost card, a move or a name change is taken in the member's words and filed as a request for your enrollment team.

Finding care

Where the provider directory lives, how to choose a primary care doctor, which number reaches the nurse line: read from the pages you approved.

Appeals, step by step

How to file, which form to use and the deadline from your member handbook, then a transfer or a ticket for the appeals team.

Messages for the right team

A caller who wants a person after hours leaves a message; the AI reads the callback number back and files it for that department.

Calls kept on the record

Each call lands on the caller's record with transcript, summary and outcome, so the next representative starts from what was already said.

The provider line

A payer call center for provider offices and billing services

Provider offices, revenue cycle teams and the patient access staff of hospitals call between patients and want one fact. The provider line gives it from your manual and passes the rest.

Claim submission addresses

Where a paper claim, a corrected claim or a reconsideration request goes, read from the provider manual your team loaded.

Filing windows and forms

The timely filing window, the forms a request needs and where an office finds them, answered without putting anyone on hold.

Status questions passed on

Claim status, eligibility and benefit checks from a health system or a practice need your systems, so they go to provider services with the claim number given and the reason.

Credentialing and contracts

Joining the network, a contract question or a payment dispute is passed to provider relations with the whole call written down.

Peak weeks

Health insurance call center services for the busiest weeks

Enrollment season

Shoppers want to know how next year's plans differ; the AI reads them your approved comparison and offers a callback with an enrollment advisor.

The new plan year

In the first days of January call volumes jump with new-card and pharmacy questions; every caller is answered on the first ring, so hold times stay short.

After a member mailing

When an annual notice or a new drug list goes out, the questions it raises are answered from that document itself.

Routing

Voice AI for health insurance that routes by reason

Departments you set

Member services, provider services, enrollment, broker support, appeals: each department's AI agent answers with its own name, voice and pace.

AI first, a person first or AI only

Each department picks how it answers, so appeals can ring a person first while plan questions stay with the AI.

Transfers announced

Your representative hears who is calling and why before taking the call, on the computer, in the phone app or on a mobile.

Supervisors on live calls

A supervisor can follow a live member call in real time, then read the written call and its summary once it ends.

Guardrails

What the payer call center AI never decides

Coverage

Whether a person is covered is never stated by the AI; the question goes to the team that can read your eligibility system.

Member costs

What a visit, a drug or a procedure will cost a member is left to your representatives, who can see the member's account.

Claims

The AI never pays, denies or predicts a claim, and claims processing stays with your team; it explains how a claim or an appeal is submitted.

Prior authorization

Every prior authorization decision stays with your clinical review team; the AI can say how a request is sent, from the provider manual.

Medical advice

A caller describing symptoms hears the wording you approved, such as calling 911 in an emergency, and is passed to your nurse line.

Your own people only

AI Phone is software on your numbers, not agents for hire: every person a caller reaches is one of your own representatives.

Compared

Payer call center AI, an outsourced center or a phone menu

What the line needs	A phone menu and hold queue	An outsourced call center	AI Phone
A member's first question	Options to listen through, then a wait	An agent reading your scripts	Answered on the first ring: in the member's own words
Plan answers	Recorded messages	Training binders you send	Your documents and approved answers: read by the AI on every call
A claim or eligibility question	A queue for your staff	A ticket sent back to you	Your member or provider services team: told who is calling and why first
Peak weeks	Longer holds	More agent hours to buy	Every call answered: with no hold queue on your number
The record	A call log	Notes in their system	Transcript and summary: on the caller's record after every call

Set-up

Set up the payer call center AI in 2 minutes

Forward your lines

Forward the member line and the provider line of your contact center to the Front Office; the numbers on your cards and manuals stay the same.

Tell Lisa your teams

Name the departments, their hours, the languages your representatives speak and which questions always go to a person.

Give her the documents

Benefit summaries, the member handbook, the provider manual and your approved answers become the only sources the AI answers from.

Read a week of calls

Run the Front Office free for 7 days with no credit card and read the transcript of every member and provider call.

Questions & answers

Questions about payer call center AI

What is payer call center AI?

Payer call center AI is software that answers a health plan's member and provider calls with AI voice agents for health insurance support lines instead of a hold queue. AI Phone does it on your own numbers: it answers from your plan documents and approved answers, routes by reason and language, and hands the calls that need a decision to your representatives.

How is AI used in call centers at health plans?

Mostly for the use cases that repeat: where is my ID card, how does my deductible work, where do I send a corrected claim, how do I file an appeal. AI Phone answers those from your documents, takes messages and requests, and passes eligibility, claim status and every decision to your people with the transcript attached.

Is AI going to replace health plan call centers?

No. AI agents take the repeated calls and the overflow when call volume peaks, so your representatives keep the conversations that need judgment: a denied claim, a member's own benefits, a grievance, a confused caller. Each department chooses AI first, a person first or AI only, so your managers decide where the AI answers and where a person does.

How is payer call center AI different from a healthcare call center for clinics?

Most healthcare call centers and healthcare contact centers are built for healthcare organizations that see patients: patient calls, appointment scheduling and a clinic's front desk. A payer's contact center hears members, brokers and the patient access teams of health systems about benefits, claims and enrollment. AI Phone answers those from your plan documents, while claims processing and prior authorizations stay with your team.

Can we keep the numbers printed on our ID cards and provider manuals?

Yes. You forward each line to your Front Office and the AI answers from that moment, with no porting and no new phone system. If you later want a number moved in, the port is handled with your carrier, or a new local number can be added.

What does the AI say when a member asks if a service is covered?

It never says whether a service is covered or what the member will owe. It explains the general terms from your plan documents, such as how a deductible or coinsurance works, then offers a representative or a callback for the member's own benefits.

Can provider offices get claim status from the AI?

Claim status, eligibility checks and benefit details that need your systems are passed to your provider services team. The AI answers what your provider manual covers, such as claim addresses, the timely filing window and how to ask for a reconsideration, and passes the rest with the call written down.

How are calls transferred to a representative?

The AI tells your colleague who is calling and why before the call connects, and the colleague takes it on the computer, the phone app or a mobile. The pickup time is kept on the Forwarded list, and the conversation so far stays on the caller's record.

What happens after hours, on weekends and on holidays?

Outside your hours each department follows the rule you chose: full AI service, messages only or voicemail. On a holiday callers hear the message you wrote for that day, and every message waits for the right team with the callback number read back digit by digit.

Does the AI handle member calls in other languages?

Yes. Members and provider offices speak their own language and the AI answers in it, from the same approved plan wording. Calls can also be routed by language, so a caller who needs a person reaches a representative who speaks it.

Is every member call recorded?

Every call the AI answers is written down with its transcript and summary on the caller's record. Audio recording is a separate setting, off until you switch it on; then callers are told, and recordings are kept only for the days you choose.

How quickly can a health plan go live with AI Phone?

Set-up takes 2 minutes: forward the member line, tell Lisa your departments and hours, then give her the plan documents and approved answers. The Front Office is free for 7 days with no credit card, so you read real member calls before you decide.

Keep exploring

Where next?

Start with the one thing you need. Add more anytime by asking Lisa.
AI Front Office for Health Payers ›

Award-winning AI

Winner at CES 2026, ISE 2026 and TMCnet Enterprise AI Product of the Year.