CASE STUDY
Leading national health plan automates primary care scheduling at scale
Getting a primary care appointment shouldn’t require a phone call, a hold queue, and a callback. But for millions of Americans, that has been the reality – not because physicians are unavailable, but because the process of booking an appointment is largely manual and time consuming.
One of the nation’s largest health plans partnered with Infinitus to change that, piloting a voice AI agent that autonomously calls provider offices to find and confirm appointments on behalf of members. All the members have to do is make a simple request through the health plan’s app.
Key outcomes
- 97% success rate: appointments successfully booked on behalf of members
- 590 hours of member time saved in the first half of 2026: the equivalent of 35,400 minutes members didn’t spend on hold
- 2.9 average calls per appointment booked, and falling: as the agent learns optimal call timing at the provider level, fewer attempts are needed to reach a successful outcome
“Members open the health plan’s app and request a primary care appointment, once they select a preferred physician and a desired scheduling window, the Infinitus AI agent activates automatically.”
Challenge: Members couldn’t book the care they were already entitled to
Health plans have long wanted to give members a seamless, digital pathway to the physicians in their network. The barrier isn’t the network itself; it’s the last mile. Unlike consumer platforms that rely on pre-negotiated scheduling slots, most primary care offices manage availability internally, over the phone. That means any digital member experience still terminates at a phone call.
The health plan’s digital product team set out to solve this by building a mobile app experience where members could set their scheduling preferences and have the system take it from there, without putting the member on the phone and without requiring providers to change their existing workflows.
Solution: An app-native experience and AI agent that calls providers on members’ behalf
Today, when select members open the health plan’s app and request a primary care appointment, once they select a preferred physician and a desired scheduling window, the Infinitus AI agent activates automatically. It calls the provider’s office, communicates the member’s preferences, and works to confirm an appointment that meets their timeline.
The member sees a confirmation in the app and via email. The agent also learns over time: by tracking when individual provider offices are most responsive, it optimizes call timing at the provider level, reducing the number of attempts needed to reach a successful outcome with each passing week.
Result: Fewer barriers, better access, a smarter agent
In the first six months of 2026, the Infinitus AI agent has saved members 590 hours – time previously lost to hold queues and callback windows. The agent is completing tasks at a 97% success rate, and the number of calls required per appointment is already trending downward as the system accumulates provider-level intelligence.
For the health plan’s digital team, the outcome is a measurably better member experience: leading to higher app engagement, improved NPS, and on the Medicare side, meaningful contributions toward STARS performance.
More broadly, the program is establishing the data and operational foundation for what comes next: a more comprehensive, agentic member services experience – one where scheduling, referrals, and care coordination all flow through a single intelligent layer.
