TREVOSE, PA — WellNet Healthcare is deploying artificial intelligence to automate provider inquiries across its medical, dental and vision plans, selecting EHVAhealth’s conversational voice technology to reduce administrative workloads and accelerate responses to eligibility, benefits and insurance claims questions.
The third-party health plan administrator will integrate the technology with its existing Five9 contact center and Salesforce customer relationship management system, allowing automated agents to handle routine inquiries while transferring more complex calls to employees.
EHVAhealth, the healthcare payer platform developed by EHVA.ai, announced the agreement as WellNet began deploying the technology across its provider services operations.
The system will handle inbound calls from healthcare providers seeking information about member eligibility, covered benefits, deductible balances, out-of-pocket spending and claims status.
The deployment targets a recurring administrative expense for health insurers and third-party administrators, whose service representatives handle large volumes of inquiries about coverage and payment processing.
By automating those interactions, WellNet aims to reduce the time employees spend answering routine questions while maintaining access to live representatives for cases requiring additional assistance.
The AI agents are designed to operate around the clock, providing responses to provider inquiries outside conventional call center hours.
When a caller requires assistance from a WellNet employee, the system will transfer the call along with information collected during the automated conversation, reducing the need to repeat details.
Call activity will also be recorded in Salesforce, allowing WellNet to maintain records of provider interactions across automated and employee-assisted services.
The integration is designed to operate within WellNet’s existing technology infrastructure rather than requiring replacement of its contact center or customer management systems.
“EHVAhealth fits into the Five9 and Salesforce tools our team already uses, so we can deliver faster service on eligibility, benefits, and claims without disrupting how we work,” said Kathy Samanns, WellNet Healthcare’s chief operating officer.
The deployment reflects an effort by health plan administrators to use AI for repetitive administrative functions while reserving employees for inquiries requiring judgment or additional investigation.
For healthcare providers, eligibility and benefits verification are routine steps in determining insurance coverage and patient financial responsibilities. Claims status inquiries also play a role in tracking reimbursements and managing billing operations.
EHVAhealth’s platform is designed for health plans, third-party administrators, insurers and benefits administrators that manage substantial volumes of provider calls.
The company said its technology can be integrated into existing contact center and customer management platforms, allowing organizations to introduce automated services without replacing their established systems.
“Plugging into an existing contact center instead of replacing it is how we get TPAs live in weeks, not quarters,” said Jeff Schaffer, chief revenue officer of EHVA.ai.
The agreement expands EHVAhealth’s use in health plan administration while giving WellNet an automated system for handling routine provider inquiries across multiple insurance benefit categories.
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