Delfino AI

Delfino AI is an AI-powered platform that automates phone calls to insurance companies and other payors on behalf of healthcare providers. This innovative system navigates Interactive Voice Response (IVR) systems, waits on hold, and communicates with live representatives to obtain critical information for tasks such as eligibility verification, benefit checks, prior authorization inquiries, and claim status updates.

Key features:

- IVR Navigation: Efficiently navigates complex IVR systems to reach appropriate departments or representatives.
- Live Conversation Handling: Engages in conversations with live representatives to ask specific questions and gather required information.
- Automated Call Requests: Allows users to submit call requests with specific questions, which the AI then handles independently.
- Time-Saving Automation: Streamlines time-consuming phone calls, enabling staff to focus on higher-value tasks.
- Knowledge Retention: Maintains institutional knowledge despite staff turnover.
- Scalable Support: Offers flexibility to scale support as needed.

How it works:

1. Users submit call requests with patient information and specific questions for the payor.
2. Delfino AI's platform places the call, navigates the IVR, and converses with a live person to obtain answers.
3. The platform relays the gathered information back to the user.

Use of AI:

Delfino AI utilizes generative AI to handle natural language processing tasks required for navigating IVR systems and conversing with live representatives. This technology enables the platform to understand and respond to complex verbal interactions, mimicking human conversation patterns.

Target users:

- Healthcare providers (hospitals, clinics, medical practices)
- Administrative staff handling insurance verifications
- Prior authorization specialists
- Claims management personnel

How to access:

Delfino AI is available as a web application, allowing users to submit call requests and receive information through an online interface.

Use cases:

- Eligibility and Benefit Verification: Confirming provider network status and copay amounts
- Prior Authorization: Checking requirements and status of existing authorizations
- Claim Status Inquiry: Obtaining updates on insurance claims