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Healthcare RCM

Eligibility, benefits and claim-status calls to payers

Eligibility, benefits and claim-status calls are the classic hold-music tax on a revenue-cycle team. Dialfetch works the payer IVR, waits, and returns the answer against the fields you asked for.

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the problem

RCM staff burn hours per day on payer hold queues just to confirm eligibility or chase a claim status.

example goals

You submit a plain-language goal; Dialfetch places the call, works the phone tree, waits on hold, and returns a structured answer.

goalConfirm eligibility and the copay/deductible for member benefits under a given plan.
goalGet the status of a submitted claim and, if denied, the denial reason and next step.
goalConfirm whether a specific CPT code requires prior authorization under the plan.
what it calls

Commercial payer provider lines, Medicaid/Medicare contractor lines, benefit desks.

what you get back

A structured answer against fields you define, plus an outcome, transcript and recording.

statuscopaydeductibleprior_auth_requireddenial_reason

Safety: Dialfetch will not read out SSNs or other sensitive identifiers on a call; provide references in the goal context instead.

Put the phone calls on autopilot.

Give it a number and a goal. Get a structured answer back — over an API, a dashboard, or MCP.

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other use cases
Insurance brokersLendersTitle companiesProcurement teams