AI for healtchare payers
Smarter conversations. Better health outcomes
Observe.AI empowers healthcare payers to elevate member experiences with fast, personalized, and reliable support at scale. Fully automate routine interactions for instant, secure, and accurate 24/7 claims, pre-authorization, and prescription support. Assist representatives with real-time guidance to resolve complex and sensitive member conversations.
With built-in automated quality assurance (QA) and omnichannel insights, payers can proactively improve performance, streamline operations, and continuously enhance the member experience from initial enrollment through long-term care.
Proven impact across 350+ enterprises
90%+
first call resolution
22%
uplift in CSAT
20%
faster routing
97%
improvement in compliance monitoring
Use cases
Your everyday processes: optimized
Banking and financial services organizations see remarkable improvements and ROI with Observe.AI across these everyday use cases.
- Reissue ID cards
- Smart routing and authentication
- Policy and coverage questions
- Claims status and approvals
Payer benefits
Customer care. With no extra co-pay.
Healthcare payers achieve remarkable improvements and measurable ROI by leveraging Observe.AI across these essential workflows.
Invest in growth
Claims Status Automation
Instantly handle members’ submissions and status inquiries while significantly reducing call volume and wait times.
Prior Authorization Processing
Automate to streamline pre-approvals while ensuring accuracy, compliance, and faster resolutions.
Prescription Benefit Verification
Provide members with immediate answers regarding medication coverage, alternatives, cost, and pharmacy networks.
Member Enrollment Support
Efficiently manage enrollment questions, eligibility verification, and policy information with automated, compliant responses.
See how Observe.AI works
Our AI-powered conversation intelligence solution is here to help your team derive more value at every stage of customer engagement.
VoiceAI Agents
Automate your high-volume, complex customer calls with agentic AI that understands caller intent and resolves inquiries with human-like eloquence.
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Real-time AI
Increase promise-to-pay rates and replicate loyalty-boosting behaviors with real-time agent assist, smart scripts, rebuttal prompts, and after-call summaries.
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Post-interaction AI
Automatically QA 100% of interactions to drive better service quality through targeted coaching and reduce financial fraud risk.
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Business Insights
Tap into millions of critical business insights to drive data-backed revenue, customer engagement, and operational efficiency decisions across the enterprise.
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VP Product, AI and Platform
