Opkit, providers of a generative artificial intelligence call center platform for the healthcare industry, has launched a platform that automates back-office phone calls for medical clinics.
The Health Insurance Portability and Accountability Act (HIPAA)-compliant platform manages outbound calls to payers for insurance verification, claims, and prior authorization, 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.
With this solution, clinic staff set up phone call tasks, such as verifying a patient's insurance coverage, and then the generative AI technology handles the calls, navigating interactive voice response trees and waiting on hold when necessary. Calls are recorded, transcribed, and made available for staff to review upon completion. Users can define custom data fields for Opkit to extract and download the results in CSV or XLSX format.
"For better or worse, today's healthcare system runs on manual phone calls. 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," said Sherwood Callaway, co-founder and CEO of Opkit, in a statement. 'Some back-office phone calls are simple to automate, but others are very complex, too complex for current AI. 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 determines whether a call should be handled by AI or a human. If an AI call fails, Opkit automatically creates a replacement and routes it to a human.
"Conversational AI is incredibly powerful, but it isn't a solution by itself," said Justin Ko, Opkit co-founder, in a statement. "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 charges based on the number of calls they initiate and the duration of those calls. The solution automatically scales up and down with call volume, so clients only pay for what they use. It can handle many calls at once.
Opkit is now developing integrations with electronic health record, CRM, and patient management systems that will allow for automatic triggering of phone call tasks at key moments, such as when a new patient schedules an appointment.