AI Voice Agents for Patient Outreach
Inbound and outbound AI voice agents for care-gap and billing outreach, answering faster and reaching every patient.
The Opportunity
A multi-location healthcare provider network ran patient outreach at the pace its phone staffing allowed, which fell well short of what its patient panel needed. Patients calling in waited in queue whenever call volume outran the people on shift, and long holds turned into abandoned calls and unbooked visits. On the outreach side, care-gap and billing lists were worked from the top until the day ran out; the patients further down the list were simply never reached that day, or that week. The calls themselves were mostly routine: reminders, scheduling, straightforward billing questions, but each one still consumed staff minutes, and the only lever the network had for reaching more patients was hiring more callers.
The gap was structural: outreach volume grows with the patient panel, while call capacity grows only with headcount. But the bulk of the call traffic followed predictable patterns a well-designed conversation could carry. If routine inbound calls could be answered immediately and routine outbound calls placed at scale, staff time would concentrate on the conversations that require a person, and outreach would stop being rationed by the day's staffing. The network needed voice agents patients would actually talk to, with natural conversation tuned to each scenario and HIPAA-aligned controls governing what the system handles and how it handles it.
Key Challenges
Whenever volume outran the shift, flu season above all, patients hung up and visits went unbooked.
Care-gap and billing outreach stopped where dialing time ran out, so the bottom of the list never got a call.
Routine reminder and billing calls consumed hours staff should have spent on conversations that need judgment.
The only lever for reaching more of the panel was hiring more callers, with no other way to absorb growth.
The Process
Mapped call traffic and isolated the high-volume, routine scenarios suited to automation: care-gap outreach and billing conversations. Complex clinical conversations and sensitive situations stayed with staff by design.
Inbound and outbound flows were designed separately for each scenario, with natural phrasing and clear escalation paths to a staff member whenever a call moves beyond the agent's scope.
The agents were built and tuned against real call scenarios, with HIPAA-aligned controls governing every interaction. The standard throughout was a call patients complete and a conversation they stay in.
The agents ran across care-gap and billing flows while Ajaia refined handling toward production readiness, adjusting wherever patients hesitated, dropped, or asked for a person, so the flows improved from live behavior rather than assumptions.
Our Solution
AI voice agents that answer inbound calls and work outbound lists naturally, at whatever volume arrives. On the outbound side, the agent reaches every patient on the care-gap list with natural outreach calls, every name on the list, regardless of staff availability. It handles routine billing calls in natural conversation, freeing staff from repetitive outreach. It answers incoming calls immediately and places outbound calls at scale, with each flow tuned to its scenario.
Key Capabilities
Impact
Average pickup time fell by 2.5 minutes, meaning inbound patients get answers before they give up and hang up. A quarter of cases, 25%, are handled autonomously from greeting to resolution, with no staff involvement at all. Since every patient on an outreach list now actually receives a call, conversions improved 30%. Outreach is no longer rationed by the day's schedule. Staff spend their phone time on conversations that need judgment, and the network reaches its whole panel without adding call-center headcount.
Key Results
- Patients calling in reach a live answer 2.5 minutes sooner, reducing the hold times that lead to abandoned calls
- 25% of cases handled autonomously from greeting to resolution with no staff touch
- Every name on a care-gap or billing list is dialed, and conversions improved 30%
- Staff phone time now goes to the calls that need a person
- The network works its full panel without adding call-center seats when volume spikes
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