The Role of AI Agents in Automating Clinical and Administrative Healthcare Calls to Improve Patient Outcomes and Provider Efficiency

Healthcare providers in the United States face many problems that affect patient care and office management. According to the Association of American Medical Colleges (AAMC), the U.S. will be short about 124,000 full-time doctors by 2025. This shortage makes it harder for patients to get timely care and for staff to support administrative tasks.

Medical call centers and offices get a large number of calls about scheduling appointments, prior authorizations, prescription refills, checking benefits, and patient questions. Call centers often see nearly 50% of staff leave, and about 70% of calls have hold times over 45 seconds. Long wait times cause around 60% of callers to hang up before talking to an agent. This leads to missed appointments, lost money, and unhappy patients.

Staff also feel more tired from repeating boring administrative work. Doctors spend almost two hours on paperwork for every hour spent with patients. Nearly one-third of doctors say they spend 20 or more hours each week on paperwork and prior authorization. This reduces time for patients and adds stress and burnout.

Given these problems, AI-powered voice agents could help reduce the pressure caused by many calls and heavy administrative work.

What Are AI Agents in Healthcare Calls?

AI agents in healthcare act as digital helpers. They understand and talk on the phone using natural language, like a human would. They use tools such as natural language processing (NLP), large language models (LLMs), and machine learning (ML) to talk with patients, providers, and insurance companies. These AI systems handle common tasks on the phone.

  • Scheduling, rescheduling, and confirming appointments
  • Handling prior authorization calls and checking insurance
  • Requesting prescription refills and sending medication reminders
  • Patient triage and gathering symptom information
  • Answering common questions
  • Checking benefits and claims status

AI agents work all day and night with steady accuracy. They help fix problems like long wait times, many dropped calls, and not enough staff.

Impact on Provider Efficiency and Patient Outcomes

An example of AI voice agents in healthcare is the platform Infinitus. It has handled over 6 million calls and automated over 100 million minutes of talk time for 125,000 healthcare providers across the country. These AI agents finish calls about 30% faster than humans and provide data that is about 10% more accurate, with fewer mistakes.

Benefits healthcare organizations see from AI voice agents include:

  • Good return on investment (ROI): Providers save around 50% on costs after using AI, mostly by saving staff time and working more efficiently.
  • Less staff workload: Automating regular calls lets staff focus on more complex patient problems. This reduces stress and staff leaving. For example, Mercalis helped 50% more patients without hiring more staff, because AI saved many staff hours each week.
  • Better patient communication: AI agents keep steady contact with patients and customize interactions, helping care coordination and satisfaction. Zing Health said AI helped bring patients onboard and allowed staff to focus on patients with urgent needs.
  • Higher data accuracy: AI makes fewer errors than humans when entering data. Infinitus reported about 10% better accuracy with AI, which helps with better medical decisions and office work.
  • Fast setup: AI voice agents can start working in less than 30 days, so offices can get benefits quickly.

These improvements help patients by making scheduling faster, prior authorizations quicker, and reducing care delays. They also help healthcare organizations lower costs and keep staff longer.

Enhancing Front-Office Workflows with AI Automation

The front office, where patients first contact healthcare offices, benefits from AI agents. Many phone calls there are routine and repeat often, using much staff time. Automating these calls shortens wait times and makes patients happier. It also helps the office work better.

Appointment Scheduling and Management: AI voice agents can book appointments automatically and send reminders. This cuts no-shows by up to 30%. They update calendars and manage time slots to reduce scheduling mistakes and staff work by up to 60%. Having 24/7 access to scheduling also helps patients get what they need more easily.

Prior Authorization Automation: Prior authorizations take up a lot of staff time. Doctors do about 43 prior auth requests each week. AI agents can do up to 75% of these tasks by checking insurance, getting payer information, and sending authorization requests. This speeds up approvals, reduces denials, and lowers staff stress.

Benefits Verification and Claims Processing: AI agents connect with systems through APIs to check benefits in bulk. This makes authorizations flow better inside the existing workflows. For example, Salesforce shows how this saves time and cuts errors in pharmacy benefit checks.

Patient Triage and Intake: AI virtual triage gathers symptoms and medical history before patients speak to staff. It helps decide who needs urgent care and improves emergency room use. Automated symptom checkers guide patients to the right care, avoiding unnecessary ER visits.

By automating these front-office jobs, healthcare offices run smoother, use staff better, and make patients happier.

AI and Workflow Automation in Healthcare Settings

AI automation is not just for phone calls. It also helps improve whole workflows by linking with electronic health records (EHR), customer systems (CRM), and scheduling platforms to keep things running well.

Healthcare office work uses AI to handle paperwork, billing, coding, and communication. This lets clinicians spend more time with patients. For example, generative AI cuts documentation time by nearly 45%, which reduces clinician burnout a lot. Some AI assistants have lowered paper work per patient from 15 minutes to 1 to 5 minutes in some clinics. This means more time for patient care.

AI agents also use natural language processing (NLP) to write down calls, get data, and update EHRs automatically. This makes data better and clinical notes more accurate. Oracle Health’s Clinical AI Agent manages patient care from start to finish while syncing data with EHRs in real time.

Many healthcare leaders focus on working more efficiently. About 83% aim to boost worker performance and 77% want productivity gains from generative AI. AI agents help by handling simple, repeated tasks.

AI also helps call center agents during live calls. It suggests answers, shows patient info, and gives next-step advice. This makes calls faster and better while lowering human errors.

Another useful feature is multilingual support. Over 350 languages are spoken in the U.S. AI can translate in real time to help patients talk more easily. Still, human interpreters are needed for cultural accuracy.

Adoption Considerations for Medical Practice Administrators and IT Managers

When healthcare offices want to start using AI agents for calls, leaders should think about several things to make it work well:

  • HIPAA Compliance and Data Security: AI must follow privacy laws. Platforms should have strong security like encryption, safe cloud storage, access limits, and legal agreements to protect patient info.
  • EHR and Workflow Integration: AI should connect smoothly with existing EHRs (like Epic, Cerner, Athena Health), scheduling, billing, and CRM systems. This avoids manual data entry and keeps records accurate.
  • Staff Training and Change Management: Staff should learn how to work with AI. Starting with simple tasks like booking appointments or after-hours calls helps build trust and shows clear benefits.
  • Rapid Deployment Capability: Many AI companies say their systems can be ready in less than 30 days, letting offices test and improve fast.
  • Customization and Learning: AI should understand clinic-specific words and routines, and get better from experience.
  • Patient Experience Considerations: Virtual assistants should talk naturally to keep patients engaged, reduce hold times, and make calling easy.
  • Scalability: AI agents should handle large call volumes and many providers so small clinics and big health systems both can use them.

Real-World Experience and Results with AI Agents

Several healthcare leaders have shared how AI voice agents helped their work.

  • Meghan Speidel, COO at Zing Health, said AI agents help with patient engagement during sign-up and let staff focus on patients needing urgent care.
  • Jeff Buck, VP at Cencora, said AI calls finish 30% faster with 10% better quality because of fewer mistakes and clearer communication.
  • Sini Abraham, Senior VP at Mercalis, said AI allowed supporting 50% more patients without extra staff by saving many hours of admin work weekly.
  • Todd Boyd, Senior Director at Amgen’s SupportPlus Call Center, said AI systems improve accuracy and adapt better when handling complex healthcare calls.
  • Google Cloud’s Aashima Gupta, said AI can make healthcare more responsive and save money.

These examples show AI voice agents help healthcare offices run better and improve patient care, especially when staff are short and admin work is heavy.

AI as a Solution to Persistent Healthcare Operational Challenges

Healthcare call centers and offices will likely keep facing more calls and heavier admin work while having fewer staff. AI agents offer a way to automate important but repeated tasks. They help cover access gaps and lower provider burnout.

AI handles appointment scheduling, prior authorizations, benefits checks, and patient triage calls. This makes offices more efficient so they can better care for patients and use resources well. AI also cuts errors and makes call data more accurate, which helps medical decisions.

As AI voice agents improve, healthcare leaders, practice owners, and IT managers in the United States should think about adding these tools to their front-office tasks. Doing so can lead to quick setup, clear cost savings, and happier patients.

The use of AI in healthcare communication is changing administrative tasks while letting providers spend more time on patient care. For healthcare groups wanting to improve work and patient relations, AI voice agents offer a useful and timely tool.

Frequently Asked Questions

What types of calls can healthcare AI agents handle?

Healthcare AI agents can handle both clinical and administrative calls to patients, payors, and providers, automating routine communications while strengthening relationships and improving patient outcomes.

How do AI agents improve productivity in healthcare?

AI agents automate or augment team tasks, enabling staff to focus on higher-impact activities. This boosts productivity by freeing staff from repetitive duties, allowing more time for patient engagement and complex administrative functions.

What scale of operations has Infinitus AI agents achieved?

Infinitus AI agents have automated over 100 million minutes of conversations, completed more than 6 million calls supporting over 125,000 providers, demonstrating infinite scalability and extensive real-world application.

What are the key benefits of using Infinitus healthcare AI agents?

Key benefits include approximately 50% ROI, 10% increased data accuracy, faster call handling (around 30% quicker), improved communication quality, and enhanced patient engagement and outcomes.

What industries within healthcare do Infinitus AI solutions support?

Infinitus AI solutions support a variety of healthcare sectors, including pharmaceutical companies, specialty pharmacies, payors, health systems, ambulatory surgery centers, and labs and diagnostics.

How do AI agents impact patient and provider engagement?

By automating routine interactions, AI agents create more time for personalized patient and provider engagement, thus improving care quality and satisfaction.

What do healthcare leaders say about Infinitus AI agents’ effectiveness?

Healthcare executives report significant improvements in efficiency, personalized engagement, cost reduction, and rapid deployment, which collectively enhance overall care quality and operational productivity.

How quickly can Infinitus AI agents be deployed in healthcare settings?

Infinitus AI agents can be deployed in less than 30 days, an unusually fast turnaround in the healthcare sector, allowing rapid realization of benefits.

What technology enables Infinitus AI agents to understand and process calls effectively?

Infinitus uses advanced natural language processing to navigate calls intuitively and convert conversations into accurate data that integrates seamlessly into healthcare systems.

How do AI agents contribute to data accuracy and error reduction?

AI-driven conversations reduce miscommunications and typographical errors, resulting in about 10% higher data quality compared to human interactions, which supports better clinical and administrative decisions.