Comprehensive Solution Performs Calls Faster, More Accurately, and Less Expensively than Offshore BPOs and Regular Staff
New York – Aug. 7, 2024 – Opkit, a generative AI call center for the healthcare industry, announces its HIPAA-compliant, AI-powered software platform that automates back office phone calls for medical clinics. The platform manages outbound calls to payers for insurance verification, claims, and prior authorization, as well as calls to pharmacies for prescription checks, and calls to collect medical records. Opkit’s AI solution is supported by a human-in-the-loop to monitor performance, handle edge-cases, and facilitate further AI training.
The process is simple: clinic staff set up phone call tasks—such as verifying a patient’s insurance coverage—and then the generative AI technology handles the calls themselves, navigating Interactive Voice Response trees and waiting on hold when necessary. Calls are recorded, transcribed, and made available for staff to review upon completion. Customers can define custom data fields for Opkit to extract and download the results in CSV or XLSX format.
An article published by the Journal of the American Medical Association Network points out that, where most service industries have fewer administrative staff than specialized staff, the U.S. healthcare industry has two administrators for every specialized person. This is in large part due to inefficient communications: medical offices, payers, and pharmacies continue to rely on phone calls to exchange information even when electronic methods would be better.
“For better or worse, today’s healthcare system runs on manual phone calls,” said Sherwood Callaway, Co-Founder and CEO at Opkit. “The industry has been slow to adopt electronic transactions, mainly because payers are not incentivized to streamline these processes. There’s also HIPAA, which makes it risky for healthcare companies to share data.”
“Some back office phone calls are simple to automate, but others are very complex–too complex for current AI,” Callaway continued. “What happens when the AI doesn’t understand a speaker’s accent, or when the person on the other end of the call refuses to speak to the AI and hangs up? That’s where Opkit’s human-in-the-loop approach comes in.”
Opkit’s algorithm makes the initial determination whether a call should be handled by an AI or a human. If an AI call fails, Opkit automatically creates a replacement and routes it to the human team, a system that ensures a higher likelihood of success.
Adding a human team means Opkit’s solution can handle complex use-cases right from the start, as well as build up data that can be used to improve Opkit’s AI, enabling it to handle similar scenarios in the future.
“Conversational AI is incredibly powerful, but it isn’t a solution by itself,” said Justin Ko, Opkit Co-Founder. “AI needs to be embedded in a useful product and supported by a team of humans that can monitor performance and step in when it fails. That’s where we invested our efforts.”
Opkit’s solution comes with a developer API so software engineers can add “self-driving” phone calls to their applications without having to implement this complex functionality from scratch.
Opkit’s current beta clients include virtual weight-loss clinic Fella, whose staff have been freed up to focus on patient support and enrollment instead of spending hours calling pharmacies to check on prescriptions and hard-to-find medications like Ozempic. Another beta client, virtual nutrition clinic Flourish, says that without Opkit’s solution to verify patient’s insurance coverage and benefits during intake, they would have had to build their own call center from the ground up.
“We literally could not run our business without Opkit,” Devin Solanki, co-founder of Flourish said. “I’ve been really impressed at Opkit’s reliability and accuracy. They consistently complete calls on time and deliver high-quality results.”
Opkit charges customers based on the number of calls they initiate and the duration of those calls—an approach that ends up costing less than the average wage of an offshore call center worker or a full-time employee. The solution automatically scales up and down with call volume, so clients only pay for exactly what they use. Opkit’s ability to perform many calls in parallel allows it to work through backlogs faster than traditional call centers, and its AI-powered data extraction makes it more consistent and less error-prone than humans.
Opkit is now developing integrations with EHR, CRM and PMS systems that will allow for automatic triggering of phone call tasks at key moments, such as when a new patient schedules an appointment.
For more information, visit www.opkit.co.
About Opkit
Opkit is a healthcare software company backed by top investors including Y Combinator. Opkit’s HIPAA-compliant, AI-powered software platform automates back office phone calls for medical clinics, including insurance verifications, prescription checks, and requests for medical records. For more information, visit www.opkit.co.
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Opkit is a healthcare software company backed by top investors including Y Combinator. Opkit’s HIPAA-compliant, AI-powered software platform automates back office phone calls for medical clinics, including insurance verifications, prescription checks, and requests for medical records. For more information, visit www.opkit.co.