Transform healthcare conversations into faster resolution, greater efficiency, and better experiences.
A worked example of a phone call: a provider checks a prior authorization. After each agent reply a note states what the agent just did — verify the caller, retrieve live status, explain what is missing, capture the document, guide the next best action, and escalate to a clinical reviewer with full context.
One Agent. Multiple Healthcare Workflows.
From claims and enrollment to care management and pharmacy services, SmarTec Voice Agent helps streamline interactions across healthcare operations.
Claims
Status inquires and resolution.
Plan Information
Coverage and enrollment support.
Benefit Verification
Eligibility and coverage verification.
Appeal Status
Appeal status and updates.
Billing Inquiries
Billing and payment support.
Directory Management
Provider search assistance.
Patient Access
Scheduling and eligibility support.
RCM
Billing and claims automation.
Accounts Receivable
Balances and payment reminders.
Care Management
Outreach and care coordination.
Clinical Denials
Denial review and appeals.
Coding Support
Coding guidance and routing.
UM & Prior Authorization
Intake, review, and status tracking.
Clinical Operations
Workflow automation and follow-up.
Clinical Denials
Appeals and escalation support.
Care Management
Member engagement and follow-up.
Stars & HEDIS Support
Outreach and gap closure.
Population Health
Preventive outreach programs.
Provider & Pharmacy Services
Coverage and reimbursement support.
Prior Authorization
Intake, review, and status tracking.
Clinical Pharmacy Support
Medication and pharmacist support.
Pharmacy Claims Operations
Claims status and resolution.
Medication Adherence Programs
Refill and adherence support.
Coverage Determinations
Coverage decisions and appeals.
Real-World Scenarios
See how we’ve helped health plans, providers and PBMs unlock millions in savings and streamline operations.
Enrollment Verification
Helping members confirm coverage, provider network status, and benefits before receiving care.
Claims Status
Giving members fast, clear answers about claim status, plan payments, and out-of-pocket costs.
Gap Engagement
Helping members understand preventive care gaps and take the next step toward recommended care.
Real Results. Real Impact
Improve service availability, deliver faster, more consistent experiences across member, provider, and patient journeys.
Insights & Resources
Stay informed with the latest thinking on healthcare payer operations:
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