INFINITUS FOR PAYORS

Agentic AI member services suite

Payor organizations face rising call volumes, growing member expectations, and pressure to control costs. Infinitus enables health plans to deliver personalized, 24/7 member support at scale without adding staff. Our AI agents automate member interactions across onboarding, administrative inquiries, and proactive care navigation, reducing operational costs while improving member satisfaction and health outcomes.

The current model for member services has reached its limits

Unsustainable call center operations

Rising call volumes and member expectations are colliding with operational reality. Costs spiral as health plans struggle to contain expenses, while staff burn out handling the same repetitive inquiries about benefits, coverage, in-network providers, and out-of-pocket costs.

High-risk members fall through the cracks

20% of members drive 80% of total costs. These high-risk patients with chronic or complex conditions need personalized, continuous support to close care gaps and prevent avoidable utilization, support that traditional models can’t deliver at scale.

Infinitus solves both problems with one integrated suite

Transform member services from a cost center to strategic advantage.

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Reduce call center operational costs

Automate the high-volume member inquiries that drain resources and overwhelm call centers. Reduce call volume, decrease handle time, and free staff to focus on complex cases that require human expertise. Bend the cost curve on call center operations.

Elevate member experience and retention

Replace “please hold” with instant, personalized support, 24/7, by phone, chat or text. Members get answers about their coverage, costs, and care options in real-time, resulting in increased member satisfaction and reduced churn.

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Personalized support across the member journey

Engage high-risk members with continuous support. AI agents proactively engage members to close care gaps, schedule preventive visits, and support medication adherence before conditions escalate. Improve HEDIS and Stars scores while lowering total cost of care.

Core capabilities that drive results

Member onboarding

Set every member up for success from the start with personalized onboarding. AI agents welcome new members, explain plan basics and key benefits, capture communication preferences, conduct health risk assessments, establish themselves as 24/7 resources available by voice, chat, or text, and guide members through next steps.

Intelligent triage

Replace frustrating legacy IVR with conversational AI that asks “how can I help you?” Members seamlessly reach the help they need, whether resolved instantly by AI or routed to the right team member, eliminating hold times, transfers, and frustrating phone trees.

Administrative self service

Drive high containment rates by resolving routine inquiries from start to finish. AI agents answer member questions about coverage, provider network status, and claims status instantly. Members get accurate answers when they need them, and call centers see fewer escalations and reduced operational costs.

Proactive care navigation

Engage high-risk members proactively throughout their care journey. AI agents remember each member’s unique care journey and needs, reaching out to close care gaps, schedule preventive visits, support medication adherence, and guide next best actions for managing chronic conditions before they escalate into costly ER visits or readmissions.

Why health plans choose Infinitus

Proven member satisfaction

90% of members rate their experience positively


Superior performance

Infinitus AI agents outperform human benchmarks by >18% in specific functions


Proven at scale

>100 million minutes of conversations automated to date


Enterprise adoption

Trusted by 44% of Fortune 50 healthcare companies


Clinical + Payor Intelligence

Purpose-built for health plan workflows, powered by the largest healthcare knowledge graph built on millions of real-world interactions


Healthcare-grade safety and compliance

Built for regulated payor environments with HIPAA compliance, PHI protection, industry-leading safety guardrails, audit trails, and workflow controls

Additional resources

BLOG POST

Build vs. buy in healthcare AI: A practical framework for healthcare leaders

CHANGE MANAGEMENT GUIDE

Leading with trust: A people-first guide to AI integration in healthcare

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Together we’re putting more “care” in healthcare

Whether you’ve got a provider division that makes calls or not, payors get the benefit of partnering with Infinitus, too.