Transform Your TPA & BPO Operations with 24/7 Voice AI
coverage voice helps Third-Party Administrators (TPAs) and Healthcare BPOs deliver member support that's faster, smarter, and fully compliant, automating claims inquiries, benefit verification, and enrollment calls with 70–90% cost savings.
HIPAA-compliant AI agents handle thousands of inquiries daily, delivering 24/7 coverage, 87% satisfaction, and a 98% cost reduction per call while freeing staff to focus on complex, high-value cases.
The TPA & BPO Challenge: Rising Costs, Shrinking Margins
TPAs and healthcare outsourcing firms power America's self-insured health market, managing coverage for 150+ million employees. With coverage voice, TPAs and BPOs eliminate the bottlenecks driving cost overruns and member frustration without replacing existing systems or disrupting compliance.
Call Containment
70–85%
Faster Claims Resolution
35%
Cost Reduction
90%
Member Satisfaction
87%
How Medicare Voice AI Works for TPAs & BPOs
coverage voice functions as an intelligent voice agent built specifically for healthcare administration, answering benefit questions, managing claims status updates, processing enrollment changes, and authenticating members securely.
24/7 Member Services & Benefit Inquiries
Most TPA and BPO call centers face surges in member calls from benefits verification to provider network questions that overwhelm human teams.
- • Coverage questions ("Does my plan include physical therapy?")
- • Claims status updates (accounts for 30–40% of call volume)
- • ID card reissue and documentation requests
- • Provider lookup and plan network queries
- • General benefits and eligibility checks
Claims Administration Support
Claim-related calls are the largest operational expense for most TPAs. coverage voice automates these conversations end-to-end.
- • Real-time claim status updates
- • Missing documentation notifications
- • Explanation of Benefits (EOB) clarification
- • Appeal and grievance initiation
Enrollment Support & Benefit Changes
Open enrollment season is the most resource-intensive period for TPAs and BPOs. AI automation ensures every call is answered, even during peak demand.
- • Plan comparison and benefit explanation
- • Dependent and COBRA enrollment processing
- • Life event changes (marriage, birth, relocation)
- • FSA, HSA, and HRA enrollment assistance
HIPAA-Compliant Authentication
Healthcare data security is non-negotiable. coverage voice enforces multi-layer identity verification before every interaction.
- • Voice biometric enrollment and verification
- • Knowledge-based authentication (KBA)
- • Fraud detection and alerting
- • Complete audit logging and traceability
Why BPOs Choose White-Label AI
Leading healthcare BPOs deploy coverage voice as a white-label automation layer to differentiate their client experience without revealing the underlying platform.
Custom Voice & Branding
Custom voice and branding per client
Multi-Tenant Management
Multi-tenant sub-account management
Real-Time Analytics
Real-time analytics and performance dashboards
Flexible Pricing
Flexible pricing (usage-based or capacity-based models)
Seamless Integrations for TPAs & BPOs
coverage voice integrates effortlessly with leading healthcare administration, CRM, and claims systems, creating a single source of truth across platforms.
Salesforce
Zendesk
Snowflake
Twilio
Five9
Genesys
Salesforce
Zendesk
Snowflake
Twilio
Five9
Genesys
Why TPAs & BPOs Choose coverage voice
Purpose-Built for Healthcare Administration
Understands claims workflows, enrollment cycles, and benefit verification processes unique to TPAs and healthcare BPOs.
Proven Operational ROI
Delivers 70–90% cost reduction, 35% faster resolution times, and 87% member satisfaction with 24/7 call coverage.
Seamless System Integration
Connects directly with TriZetto, HealthEdge, Benefitfocus, Salesforce, Zendesk, and other leading platforms.
White-Label Scalability for BPOs
Supports multi-tenant deployments with client-specific branding, analytics, and billing flexibility.
HIPAA & SOC 2 Compliance Built-In
Security, audit trails, and consent verification are embedded into every interaction for total regulatory protection.
Frequently Asked Questions
A Third-Party Administrator (TPA) manages healthcare benefits, claims processing, and member support for self-insured employers and health plans.
coverage voice automates routine calls, claim updates, benefit checks, and enrollment support, reducing labor costs 70% and eliminating after-hours gaps.
Yes. The platform is fully HIPAA and SOC 2 certified, with voice biometrics, audit trails, and secure encryption.
Absolutely. coverage voice connects to leading platforms like TriZetto, Benefitfocus, Salesforce, and Zendesk through APIs or FHIR/HL7 data exchange.
Most clients go live within 45–60 days, including configuration, integration, and compliance testing.
Future-Proof Your TPA or BPO Operation
Member expectations are rising, regulations are tightening, and profit margins are shrinking. coverage voice helps TPAs and healthcare outsourcing providers meet these challenges head-on — with automation that scales instantly and operates 24/7.