AI Agents

Infinitus AI Agents is a voice AI platform designed for healthcare organizations that need to automate routine phone-based interactions with patients, payors, and providers. The platform targets pharmaceutical manufacturers, specialty pharmacies, payors, and provider networks, enabling administrative and clinical call automation to reduce staff burden and improve patient access, adherence, and affordability.

Infinitus voice AI agents report a 98% call success rate and collect data an average of 10% more accurately than manual processes. New use cases can be deployed in weeks, and calls can be escalated to a human operator when needed. The platform also includes digital AI agents that connect with clearinghouses and payors to collect data digitally before phone calls are made, reducing call length and improving turnaround time.

AI Agents That Call Patients

• Patient navigator: Contacts patients beginning treatment to answer questions, set expectations, and support adherence and overall patient experience.
• Income verification: Confirms a patient's reported income and determines eligibility for monetary subsidies or copay assistance programs.
• Medication adherence: Proactively checks in with patients to confirm they are taking medication as prescribed, and escalates reported side effects or adherence blockers to clinicians and case workers.
• Health risk assessment: Conducts routine health assessments to help patients make full use of their insurance plan benefits.

AI Agents That Call Payors

• Benefit verification: Automates retrieval of a patient's medical and pharmacy coverage details from commercial payors and Medicare. Collects plan details (deductible, out-of-pocket, plan type), network status, drug and admin coverage, coordination of benefits, prior authorization requirements, specialty pharmacy requirements, buy and bill availability, and local (MAC) and national Medicare Part B product coverage.
• Prior authorization: Determines whether a treatment requires prior authorization and retrieves current PA status, including approval details, denial reasons, and appeal options.
• Formulary exceptions: Checks whether a formulary exception has been submitted and approved, retrieves the submission process, and collects approval or denial details including appeal options.
• Appeals: Tracks the status of prior authorization or formulary exception appeals, collects approval or denial details, identifies available appeal levels, and retrieves the process for submitting appeals.
• Bridge eligibility: Periodically reverifies whether patients remain eligible for bridge programs by calling payors to check for coverage changes. Collects plan validity, product coverage status, available coverage exception options, and approval or denial details.
• Insurance discovery: Identifies a patient's current insurance plan and retrieves medical and pharmacy plan details, including payor name, subscriber ID, effective date, PBM payor name, and phone number. Can also trigger detailed benefit verification collection.

AI Agents That Call Providers

• Directory confirmation: Contacts providers to verify their information for inclusion in online directories and related systems.
• Provider education: Reaches out to providers supporting patients to answer questions, set expectations, and improve the provider experience.
• Missing information: Calls providers to collect missing documentation details, reducing delays in patient access, adherence, or therapy affordability.

Digital AI Agents

• Collects data digitally through partnerships with clearinghouses and payors prior to initiating phone calls, reducing the length of voice interactions.
• Supports electronic benefit verification (eBV) for Medicare Part B and commercial payors.
• Includes unique payor API connections for direct data retrieval.

Platform Capabilities

• Covers patient-facing, provider-facing, and payor-facing call automation within a single platform.
• Supports all stages of the patient journey, spanning clinical and administrative tasks.
• Designed for enterprise deployment with the ability to spin up new use cases in weeks.
• Includes human escalation capability when calls require intervention beyond the AI agent's scope.

Infinitus is used by healthcare organizations including Fortune 50 biotechnology companies, with documented outcomes including time savings, improved team morale, and cost reductions of hundreds of thousands of dollars annually. The platform currently supports a network of over 150,000 providers.