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The phone is the front door to your health plan

Vocalis answers it with an agent that knows your plans, resolves the routine, and hands the rest to your staff with the whole story already in hand.

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RGRojitha G.
CALL-8852Claim status · inboundObjective met4m 12s
RA
R. Alvarez0:04

Hi, I'm calling about a claim from my visit last month.

Benefits agent0:09

Happy to check. I have your record open. Is this about claim 4821, dated the fourteenth?

Grounded in Claims · Meridian PPO
RA
R. Alvarez0:18

Yes, that one. It still says pending on the portal.

Benefits agent0:22

It cleared Tuesday. Your share is $42.60, and the explanation of benefits mails this week.

RA
R. Alvarez0:31

That is a relief. While I have you, does the MRI my doctor ordered need approval?

Benefits agent0:36

Advanced imaging does need prior authorization on this plan. Review takes three business days.

Grounded in Meridian PPO 2026 · §4.3
RA
R. Alvarez0:47

Can someone call me once it goes through?

Benefits agent0:51

Booked. Our care team will reach you Thursday at two on this number.

Promise recorded · callback Thu 2:00 PM
1:31 / 4:12
Live · +1 (555) 014-220002:18
Caller

“I need to know if the MRI needs prior authorization.”

Assist

Prior auth required for advanced imaging on this plan. Turnaround is 3 business days.

Meridian PPO 2026 · §4.3

Slots into the contact center you already run

GenesysAmazon ConnectTwilioFive9NICECiscoAvayaVonageRingCentral
GenesysAmazon ConnectTwilioFive9NICECiscoAvayaVonageRingCentral

Build the agent,
hear it, ship it

Five steps from empty to live: pick the engine, pick the voice, name the fields it collects, connect the tools it can call, write the prompt. Then talk to it in the browser before a member ever does.

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VoiceEnglish · US
Marin
Warm, unhurried
Cedar
Low, steady
Sage
Calm, reassuring
Kore
Clear, professional
Benefits agent · v7DraftSave
  1. Engine
  2. Voice
  3. Fields
  4. Tools
  5. Prompt
System promptComposeVariables

You are the benefits line for {{plan_name}}.

Greet {{member_first_name}} by name. Answer only from the plan documents.

If the member asks about an open claim, call lookup_claim before answering.

Never quote a dollar amount you did not read from the record.

Test by voice in your browser
ToolsOpenAPI
lookup_claimClaims system
check_eligibilityEnrollment
book_callbackScheduling
create_ticketOpenAPI import

Every model worth running, on your keys

Run our managed speech-native engine, or assemble your own: transcription, reasoning and speech chosen stage by stage, each with its speed and cost in front of you. Swap a model without rewriting an agent.

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Engine
VVocalis Realtime

Our speech-native stack, managed end to end.

Sub-second responsesNatural turn-taking
Custom Pipeline

Assemble your own transcription, language and speech models.

DOAGC11
Speech-to-Speech

A third-party realtime model, with its own built-in voice.

OG
Custom pipeline · modelsYour keys
Transcription7 modelsReasoning11 modelsSpeech4 modelsSpeech-to-speech5 models
O
GPT-5.4 MiniRecommended
OpenAI

Fast and cheap enough to answer mid-sentence.

SpeedCost
A
Claude Sonnet 5New
Anthropic

The strongest reasoning in the catalogue.

SpeedCost
G
Gemini 3.5 Flash Lite
Google

Lowest latency to first token.

SpeedCost
A
Claude Haiku 4.5
Anthropic

Small, quick, and careful with instructions.

SpeedCost
Speech modelsYour keys
TranscriptionReasoningSpeechSpeech-to-speech
C
Cartesia Sonic 3.6Recommended
Cartesia
SpeedCost
11
ElevenLabs Flash v2.5
ElevenLabs
SpeedCost
11
ElevenLabs Turbo v2.5
ElevenLabs
SpeedCost
OOpenAIAAnthropicGGoogleDDeepgramCCartesia11ElevenLabs

Twenty-seven models across four stages. Language coverage is checked before you can pick one, so a call never fails as dead air.

Design the whole
line, not one bot

Greeters, specialists, schedulers and handoffs on one canvas. Keep a phone menu if your members expect one, and let any branch end in an agent or a person.

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Workflow · Benefits lineTest by voice
Greeter
Intent · language
Claims agent
Grounded · KB v12
Scheduler
Books callbacks
Warm transfer
Queue: Appeals
AgentToolTransferEnd
IVR · Main line
Greeting plays0:06
1ClaimsClaims agent
2Prior authAuth workflow
3Talk to a personMember queue
Knowledge base · BenefitsIndexed
Meridian PPO 2026 EOC.pdf
412 sections
Formulary Tier Table.xlsx
1,208 rows
Prior Auth Policy v4.docx
96 sections
Answer

Advanced imaging needs prior authorization. Standard review is three business days.

EOC §4.3Prior Auth Policy §2

Calls you place, calls they make, chat in between

One platform, one set of knowledge, every way a member gets in touch.

Campaign · Renewal remindersRunning
1,451of 2,340 contacts
68%
Objectives
9a to 6p
Window
3
Retries
DNC and quiet hours checked before dialing

Outbound campaigns

Pick the list and the objective, set the calling window, and let agents dial at scale.

Triggers
Inbound · (555) 014-2200
Benefits workflow
POST /v1/calls
Appointment reminders
call.completed
Posts to your CRM
{
  "agent": "benefits-v7",
  "to": "+15550142200"
}

Inbound and API

Answer on your own numbers, or let your systems start a call with one request.

Member help desk
Do you cover out-of-network urgent care?
Yes, at 70% after your deductible. Want me to check what you have left on yours?
Meridian PPO 2026 · §7.1
Write a message

Help desk chat

The same agents in writing, answering from the same knowledge, on your site.

Your people,
already caught up

A full call center for human staff: live queue, dial pad, dispositions, escalations. When a call needs a person, they inherit the claim, the history and what was promised, so the member never starts over.

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Call center · Member services12 waiting96% answered
CallerReasonWaitingHandled by
R. AlvarezClaim status0:42AI
T. NguyenNew enrollment1:06AI
J. OkaforAppeal · escalated2:10Sam D.
M. HaddadPrior auth2:55Queued
L. WhitfieldBilling question4:55Ana P.
Incoming transfer
J. Okafor
Member since 2019 · Meridian PPO
What happened so far
  • Claim 4821 denied, code CO-197.
  • Agent confirmed the appeal window is open.
  • Promised a specialist would explain the code.
Compliance · liveAll clear
DNC registryChecked before dial
Quiet hoursLocal time enforced
Consent on fileTCPA · captured 2026-02-04
Crisis languageMonitored every turn
PHI redactionApplied to transcripts

Every call analyzed, not a sample of them

Findings land the moment a call ends, each one linked to the exact second in the audio. Then ask the whole record a question in plain language and watch the answer build.

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Analysis · CALL-48214m 12s
Objective metSentiment positivePromise: callback Thu 2 PMNo DNC requestNo safety concern
Evidence

“I’ve booked a callback with our appeals team for Thursday at two.”

2:41
Resolution time by agentLast 5 months
OctNovDecJanFeb
Reports · ask your data
Which reasons drove the most repeat calls last month?
Prior authorization status82
Claim denial codes61
Deductible remaining44
ID card requests23
ShareExport CSVSchedule

A member should never have to explain the same claim twice.

Warm transfer carries the whole call

You find the problem before the member calls back about it.

Analysis on 100% of calls

Private by design, because every call carries PHI

Compliance is evaluated during the conversation, not summarised after it. Sensitive moments are flagged as they happen and the call is steered before it becomes an incident.

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HIPAA-ready architecture

End to end, with BAAs available on request.

AES-256 at rest, TLS in transit

On every call, recording and transcript.

DNC and TCPA enforced live

Checked before the dial, not reported after.

US infrastructure, full audit trail

Roles, oversight and a record of every change.

Compliance · liveAll clear
DNC registryChecked before dial
Quiet hoursLocal time enforced
Consent on fileTCPA · captured 2026-02-04
Crisis languageMonitored every turn
PHI redactionApplied to transcripts

Built for teams whose calls carry consequences

Payers and health plans

Claims, enrollment and renewals answered from your own plan documents.

Hospitals and health systems

Appointment lines and care follow-ups, with safety detection on every call.

Member services

Tickets that arrive with context, and a person on the line when one is needed.

Workspaces and roles · versioned agents · knowledge bases · OpenAPI tool import · embeddable help desks · webhooks

Make the front door intelligent

Start with one number and one agent. Grow into a call center that answers from your plans and never forgets a promise.

Get startedTalk to us
Vocalis

Voice AI for the calls your members count on.

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© 2026 Pendral Inc. All rights reserved.Multiple patents pending.A subsidiary of Evry Healthcare, Inc.