Administrative tasks in healthcare take up a lot of staff time and resources. Call centers, benefit verification, prior authorization follow-ups, and eligibility checks are some of the complex and routine phone-based tasks staff handle every day. These tasks are important for getting paid and caring for patients but often overwhelm teams and cause delays.
Companies like Simbo AI provide AI-powered front-office phone automation to help with these problems. Like Infinitus Systems, a leader in voice AI for healthcare, Simbo AI offers smart answering services that automate complicated phone calls. Infinitus handles over 100 million minutes of healthcare conversations each year and works with platforms like Salesforce Health Cloud to link AI agents directly to health information systems.
This connection improves workflow efficiency by automating many complex, high-volume tasks such as benefit verification and prior authorization status checks. Because of this, staff burnout goes down, patient wait times get shorter, and fewer administrative errors happen.
A key development in AI automation for healthcare administration is that verification actions now cover both clinical and pharmacy areas. Benefit verification means checking a patient’s coverage for medications, treatments, or procedures, and it is very important before care is given.
In the past, verifying pharmacy benefits and drug coverage meant healthcare staff spent a lot of time on phone menus and waiting on hold with different payors. This slowed down patient care and made administration less efficient.
AI agents, like those made by Infinitus, automate these checks directly through electronic links with pharmacy benefit managers (PBMs) and clearinghouses. Their voice AI agents can quickly and accurately confirm drug coverage eligibility, specialty pharmacy rules, and cost-sharing details without any human help.
Infinitus is working on a feature to verify medical benefits electronically through clearinghouses. This is a big step forward. It means healthcare providers can check not only pharmacy benefits but also wider medical benefit details like prior authorization needs, coverage limits, and patient eligibility without making many manual phone calls.
For medical practices in the U.S., this means one AI system can handle verifications for both clinical and pharmacy needs. It combines workflows and makes sure data flows directly into electronic medical records (EMRs) or practice management systems almost immediately. These improvements let staff focus more on patient care instead of administrative tasks.
Modern AI automation systems can update patient records right away based on verified information from payors or pharmacy managers.
Before, benefit verification results were often written down and entered into EMRs or software days after phone calls. This delay could cause wrong insurance eligibility on record, billing mistakes, and confusion during treatment planning.
AI automation platforms integrated with systems like Salesforce Health Cloud allow automatic and immediate updates of patient benefit details. This near real-time update helps care teams have the latest data when making clinical decisions or preparing claims.
For instance, Infinitus Systems uses FastTrack™ technology. This technology helps users skip Interactive Voice Response (IVR) systems and wait times when calling payors. Verified information from these AI voice calls updates Salesforce instantly. It provides a current summary of drug coverage, medical benefits, prior authorization status, and appeal results.
For medical practice administrators and IT managers in the U.S., this removes delays in their workflows. Patient records become more accurate, care delays fall, and billing works better, causing fewer denials because of outdated benefit info.
Advanced AI automation platforms connect to many health IT systems such as EMRs, practice management software, and payer portals. For example, the partnership between Infinitus and Salesforce lets AI agents launch from Salesforce Health Cloud or Life Sciences Cloud, using tools like MuleSoft connectors and Agentforce.
This close connection means organizations do not have to replace their current systems or train staff on new complicated tools. AI agents work inside familiar platforms, automating routine but time-consuming phone calls about eligibility verification, claims status checks, and authorization follow-ups.
AI agents cut down the administrative work for medical office staff by automating repetitive phone calls and data entry jobs. The AI takes care of tasks like patient eligibility checks, formulary exceptions, prior authorization status inquiries, and appeals, which usually need a lot of manual work.
For healthcare owners and administrators, this means lower operating costs, fewer mistakes from manual data entry, and better staff satisfaction. Staff members can focus on more important work such as patient engagement, care management, or making sure rules are followed.
Also, less human work speeds up time to treatment, which improves patient care by removing delays caused by insurance verification.
Besides helping inside the office, AI phone automation also makes the patient experience better. Automated verification systems reduce hold times and get rid of confusing IVR menus by using voice AI agents that talk naturally with payors.
Patients get faster answers about their coverage and benefits, reducing worries and uncertainty. Real-time record updates also improve how appointments and billing information are handled, leading to fewer surprises and clearer expectations.
According to research and company leaders like Ankit Jain, CEO of Infinitus, future AI tools will cover more healthcare verification and administrative tasks. Soon, medical benefits verification via clearinghouses will be available, alongside wider use of Agentforce automation tools.
These updates will increase automation for prior authorizations, appeals, formulary management, and benefit renewals. Small improvements in multimodal AI and human review (“human-in-the-loop”) will keep the system safe, secure, and accurate.
As AI grows in healthcare, 44% of Fortune 50 healthcare companies already use trusted AI platforms like Infinitus. AI-driven automation is becoming more normal as organizations try to cut down complex administration and improve operations.
In the U.S., where healthcare systems have many payors, complex benefit plans, and strict rules, AI agents will keep getting better at handling more work. They will automate more front-office jobs while linking with clinical data to give a full view of patient care and coverage.
AI automation makes communication better between providers, payors, pharmacies, and patients. Automated calls and messages manage routine verification and follow-ups without manual work, making communication consistent and on time.
With advanced AI methods like multimodal learning and knowledge graphs, healthcare AI systems capture and handle complex insurance and patient data accurately. Human-in-the-loop checks help keep compliance with laws like HIPAA, protecting patient privacy and data security.
When healthcare practices grow or face busy times, AI agents can handle many verification calls and administrative requests. Cloud-based systems can adjust to demand, lowering bottlenecks during busy periods.
Automated workflow platforms collect large amounts of data on patient interactions, benefit checks, call results, and operations. This data helps administrators find problems, improve workflows, and meet reporting rules.
By giving nearly real-time updates on patient insurance benefits and authorization status, AI systems give care teams useful data right when they need it. This cuts delays and helps avoid denials or treatment hold-ups caused by unknown benefit issues at scheduling.
For healthcare administrators and IT staff in the U.S., AI automation offers real ways to fix common operational problems. Automation platforms reduce repetitive tasks linked to payer communications and patient benefit checks, making the admin workforce more efficient.
Connecting with familiar clinical and admin platforms means little disruption when adopting AI. Real-time patient record updates improve accuracy and help patient care coordination. AI agents cut phone wait times and make payor interactions smoother, which improves patient satisfaction and revenue cycle management.
Medical practices that use AI-powered front-office systems like Simbo AI and Infinitus can:
Artificial intelligence and workflow automation are becoming important tools in updating healthcare administration in the United States. As benefit verification expands and real-time updates to clinical and pharmacy records become usual, medical practice administrators, owners, and IT managers can gain many operational benefits by adding AI-powered answering services and automated phone systems to their workflows.
Infinitus AI agents automate complex administrative phone-based healthcare tasks such as verifying coverage for drugs, pharmacy, and medical benefits, prior authorization status, and follow-up calls. This reduces staff burnout and accelerates care timelines for patients.
They launch directly from Salesforce platforms like Health Cloud and Life Sciences Cloud through MuleSoft connectors and Agentforce, allowing seamless automation of routine administrative phone calls without disrupting existing workflows.
Key use cases include verifying medical and pharmacy benefits, checking prior authorization and appeals status, and following up on product coverage and formulary exceptions with payors.
By automating routine calls and providing near real-time updates on benefits and coverage, these AI agents reduce human workload, improve response times, and minimize patient wait times, thus enhancing satisfaction and operational efficiency.
FastTrackTM initiates calls to payors and enables users to bypass Interactive Voice Response (IVR) systems and hold times, saving valuable time and improving access to information compared to conventional IVR phone systems.
Infinitus combines multimodal AI, a proprietary knowledge graph, discrete action spaces, and human-in-the-loop guardrails, which collectively ensure safe, accurate, and compliant handling of sensitive healthcare data during AI-driven conversations.
Infinitus is a trusted solutions partner to 44% of Fortune 50 healthcare companies and works with consulting partners such as Accenture, Slalom, and ZS to serve a broad range of healthcare and life sciences customers.
AI agents offer personalized, intelligent handling of complex tasks without frustrating menus and delays typical of IVRs, resulting in faster verifications, fewer errors, higher scalability, and improved patient and staff engagement.
The partnership enables automated verification of medical and pharmacy benefits, prior authorization checks, and follow-up calls from within Salesforce, supporting bulk and individual transactions with real-time updating of patient records.
Electronic pharmacy benefits verification is currently available, with out-of-the-box medical benefits verification via clearinghouses and expanded Agentforce verification actions expected by October, allowing broader automation and integration at scale.
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