Winner CES 2026 · ISE 2026 · TMCnet 2026

AI Tickets for Health Payers. AI for health insurance member services requests

AI Tickets is AI for health insurance member services that opens a ticket for every member request on the phone, in the chat, by e-mail and on your forms, with the whole conversation on it. The AI answers from your approved knowledge when it is sure enough; anything else waits for a person, and nothing is guessed.

TRY AI TICKETS FREENo credit card · Ready in 2 minutes

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

Zanus AI · AI Tickets · Held for a person

Held for a person

Each ticket held in Manual review says why it waits for a person, with the AI's score beside it, so nothing reaches a member as a guess.

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

You“Grievances and claim questions: a person always answers, within one working day.”

Lisa“Grievances and claim questions now go to a person every time, with a promise of one working day. Apply?”

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

How Health Payers use it

A member asks by e-mail how to order a new ID card; the AI answers from your knowledge and the member rates the answer.

A caller disputes a bill; the ticket opens with the transcript and waits for member services in Manual review.

A complaint about a provider is marked Urgent for the grievance team and given to the person who handles grievances.

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

What’s included

Opened from a phone call, a chat, an e-mail or a web form, with the whole conversation and the customer identified
Nights and weekends: the customer gets a number and a promise, your team gets the ticket in the morning
The AI answers from your knowledge when it is sure enough; otherwise it proposes the answer and a person sends it
Pending, manual review, responded and closed; priority, who holds it, Merge and internal notes for your team

Add it to any contact channel — AI Phone, AI Webchat, AI E-mail or AI Web Forms — or get it inside a solution · See pricing › · Per company, never per seat.

Everything AI Tickets does, for every business ›

Works withAI Phone AI Webchat AI E-mail AI Web Forms AI Returns & Warranty

Member requests

Health plan member services in one list of requests

From every channel

Calls, chats, e-mails and forms open tickets in the same list, each marked with the channel the member used.

The member identified

The contact, earlier tickets and the whole conversation are on one screen before anyone reads a word.

Held when unsure

Below the score you set, a ticket waits for a person in Manual review, and the member is never given a guess.

Grievance intake

In grievance intake for health plans, a complaint is marked Urgent and handed to the grievance team, with an internal note the member never sees.

Set-up

Member request tracking in 2 minutes

Name the departments

Member services, provider services, grievances and appeals: each gets its own rule, promise and signature.

Set how sure the AI must be

Move the threshold up for a cautious start; below it, every ticket waits for a person.

Choose who may answer

Every agent of the workspace or administrators only, signing as the department or as themselves.

Read a week of tickets

Run your member requests free for 7 days with no credit card and read every ticket and answer.

Questions & answers

AI Tickets for Health Payers: questions & answers

Can AI answer health insurance member services requests?

Yes, the ones your approved knowledge covers, such as where to find a form or how to order a card. Below the score you set, these AI solutions for health insurance customer service never send, and the ticket waits for a person.

Can grievances and appeals always go to a person?

Yes. Give the grievance and appeals departments the rule that one person answers, with their own reply-time promise and signature, and the AI only opens and files the ticket.

Is the member told when to expect an answer?

Yes. The AI tells the member when to expect the reply from the department's hours, the confirmation e-mail says it too, and a ticket past the promise is marked for your team.

Does the AI decide claims from tickets?

No. A ticket about a claim carries the member's words and the conversation to the person who handles it; the AI never says whether a claim will be paid.

How do we find what members ask that the AI cannot answer?

A question held for a person as many times as you set becomes a knowledge gap, which shows your team what to teach the AI next.

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.