Healthcare

doctor wearing a lab coat's hands holding a stethoscope
Ansafone provides healthcare call center services for small, medium and large health care networks by performing a variety of member and provider services. We currently service a member base of over 3M within just the Southern California area alone for Medi-Cal Administrators and Plan Providers. Specifically, we assist in state funded medicaid plans and Medicare benefits, Health Benefit Exchanges with informational, enrollment and language services,and for profit health plans.

Ansafone currently provides inbound and outbound medical call center services such as:

  • Member Service Support
    Ansafone’s member services team provides a navigator support role and is available 24/7 to handle member support inquiries, eligibility verification, and pharmacy services. Following customized call scripts, agents will field all questions regarding accounts, billing, claims, etc. and escalate urgent issues to your on call staff or nurse and/or pharmacy assistance lines.
  • Provider Assistance
    24-hour provider assistance with questions related to eligibility of recipients, claim status, EOBs, billing, resolution of problems, etc.
  • Emergency Dispatch
    Promptly and accurately document and dispatch your calls around the clock, designed to your specifications. Our agents follow your specified emergency protocol so that you can rest assured that each caller is handled appropriately.
  • Pharmacy Authorizations
    Ansafone can handle prior authorization tasks including determination of whether or not the prescription drug is covered, contacting the doctor to submit the request, and ensuring that the authorization has been processed.
  • Eligibility Verification
    Expedite the patient eligibility verification process with Ansafone’s reliable system. We have the ability to collect and verify patient benefit and eligibility data for you on an overflow or after hours basis. Our eligibility verification services enhance your organization’s productivity, increase patient satisfaction, and help you meet patient/members response times for CMS and other regulatory requirements on service delivery times.
  • Claims Transmission
    Rely on Ansafone’s state of the art claims transmission and medical billing services. Our system is designed to transmit a high volume of claims to increase cash flow and eliminate laborious tasks associated with processing and submitting claims. We are experienced in handling all aspects of medical billing for a variety of healthcare claims.
  • Hospice Care
    Deliver rapid, compassionate care for your patients with Ansafone’s 24-hour hospice and home care services. Our highly trained, HIPAA-compliant healthcare call center agents provide rapid response when your clients need it most. We also compile reports providing details about client information, dispatchers assigned to the client, response time, and the exact steps that were taken throughout the process. Our technology combined with our knowledge of the hospice and home care industry allows us to offer unmatched client support.
  • Member Retention
    Ansafone facilitates member retention strategies through proactive outbound campaigns. We assist members through their initial enrollment and health assessments, eligibility or re-determination process, and renewals for Healthy Kids & Healthy Families populations. Many of these initiatives are specifically designed to assist in improving providers’ overall Health Effectiveness Data and Information Set (HEDIS) scores.
  • Medical Triaging
    Medical triaging is available 24 hours a day, 7 days a week in English or Spanish to the adult population. We offer medical triage call center services to individual practitioners, hospitals, and other clients to seamlessly connect callers.
  • For Profit Health Plans
    PCP changes, facilitation of referral changes and member services support.
  • Access to Care
    We can help assist low-income, un-insured individuals with finding healthcare through eligibility screening and processing new applicant requests.
  • PCP Changes
    Our agents can assist members in finding, assigning, and changing their Primary Care Physician, as well as collect the necessary contact information to share with the new organizations.