The care exists.
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Infinitus handles the communication and coordination that sits between a patient and the care they need – from first contact to long-term adherence.

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Thanks for calling [redacted]. My name is Eva, and I am an AI agent on a recorded line. How can I help you today?

Hey there Eva.

Um, my name is [redacted] Calling because I, I'm, I'm trying to get my second fill of [redacted] and um I'm noticing that it's much more expensive than the first fill.

Uh, this time around is 150 dollars. And the first time I, I actually didn't pay anything. So, trying to figure out why it's more expensive this time.

And um, I figure I'd call.

I can certainly help you look into why the cost of your [redacted] has changed.

To get started, could you please confirm your full name and date of birth for me?

Yeah, my name is [redacted].

You've been authenticated.

Just to make sure I have this right: You're calling because your second fill of [redacted] is more expensive than your first one, which was free.

Is that correct?

Yeah, can you please look into that, please for me?

I can certainly explain that for you. Here is what I can see.

Your first fill was zero dollars under the [redacted] program while your insurer reviewed your coverage.

Now that your insurer has approved the coverage, this fill is processing under your plan's regular benefit rules instead. Does that make sense?

Uh no, that doesn't really make sense. So you're saying that now my insurance approved the medication, shouldn't that make it um…

Like how does, how does it make sense that it, it is now more expensive now that the insurance is covering it? It doesn't make sense.

I use the copay savings card and everything, I don't understand.

I understand why that would be confusing.

To be clear, your plan has set the patient share for this fill at 750 dollars [redacted] is paying 600 dollars toward that amount, which leaves 150 dollars remaining as the amount due today.

Does that help clarify how the total was calculated?

Then why was it zero the first time? I still don't get that.

The first fill was different because it was provided by [redacted].

That program is designed to give you the medication at no cost specifically while your insurance company is still reviewing your coverage. Now that the review is over…

Got it. Okay. Sorry to interrupt ya, but yeah I mean that's 150 every time is gonna be just, a little bit expensive for me.

I, I didn't expect this to be honest with you.

I hear you [redacted]. It sounds like this was an unexpected expense, and that paying 150 dollars each time is gonna be difficult for you.

I completely understand how stressful that can be.

Since this fill is now processing under your regular plan benefits, let me run a quick check with your insurance to see where you stand on your annual out of pocket maximum this year.

That can affect what you owe on future fills too. Would that be alright?

Okay, sure.

I'll run that check for you now. Looking at your plan, your annual out of pocket maximum is 3500 dollars.

So far this calendar year, you have accumulated 3250 dollars, which means you have 250 dollars remaining before you meet that maximum.

The 150 dollars due today counts toward that total.

Once you meet the maximum, your insurance will cover 100 percent of the cost, and your [redacted] cost will return to zero dollars for the rest of the year.

Does that help?

Yeah, I guess, I guess that does make me feel better about it um. But uh, what about, what about, um, like what about today?

I feel like 150 dollars is still a little bit too much for me.

Is there a way you can connect me with someone that I can talk to so that I can see if they'd help me somehow cover the cost today?

I understand. Since you're still concerned about the cost today, I can certainly connect you with [redacted] who can look into further options with you.

Would you like me to transfer you now?

Sure.

I will transfer you now. I'm going to put you on a brief hold, so please wait, just a moment.

Okay, thank you.

An Infinitus agent takes an inbound call from a patient whose copay has increased. The agent explains why, checks his out-of-pocket maximum, and transfers him to a specialist when cost is still a barrier.

Thanks for calling your behavioral health member services. This is an AI assistant on a recorded line. How can I help you today?

Yeah, I'm uh dealing with a big problem right now.

I'm sorry to hear that. I'm here to help. Could you tell me a bit more about what's going on?

You know, I've got a whole stack of bills here from my hospital stay last month, and the big one says I owe almost $4,000.

I don't have $4,000. I called about this last week, I got bounced around, and nobody could give me an answer.

I understand how frustrating it is to be bounced around when you're trying to get a clear answer. I can certainly help you sort this out right now.

May I start with your first and last name?

[redacted]

Thank you. I see that you called last week about the billing from your stay and didn't get the answers you needed.

I'll make sure we sort that out for you now. Where would you like to start?

Well, you know, I've got a stack, I've got some from the hospital, I think I have some others.

I can't really make heads or tails of any of it. But why don't we start with the big one?

One hospital stay can produce several different bills because the hospital bills for the room and care, while each doctor bills separately.

I see the hospital's bill and the psychiatrist's bill here.

If you also have a bill from a medical doctor who saw you during the stay, that one is handled by your medical plan and won't show here.

Which one would you like to start with?

Yeah, like I said, let's start with the hospital. It says I owe $4,000. Again, huge, I can't afford that.

I understand. Looking at the hospital's bill, it looks like the charge you're seeing is for a private room. The claim is missing the code hospitals…

A private room? I'm sorry. I never paid for… well I never asked for a private room.

I understand. The claim is missing the code hospitals use to report that no standard room was available, so it processed as if you chose the private room.

Under your plan's policy, if you didn't request it and none were available, that difference should not be yours to pay.

I can open a billing review with the hospital so they can confirm what happened and send a corrected claim if appropriate.

Would you like me to open that for you?

Yeah, that that's fantastic. So I may not owe this bill amount?

I have opened that review for you. The reference number is [redacted]. It can take up to 30 days to resolve.

Please do not pay the disputed room difference while the review is open, though the copay is separate from this. Does that make sense?

Yeah, I mean like I said, that's pretty good news, right?

It is a good step forward. Now I also want to go over the days of your stay that were denied.

Yeah, let's do it.

For your stay, the first five days were covered, but the extension for the last four days was denied.

The hospital asked for payment for those days, but the plan said no.

The good news is that you owe nothing for those denied days because that is a matter between the plan and the hospital.

I can provide a written determination letter with the criteria used for that decision free of charge, and you have a 180-day window to appeal it.

Does that help?

Uh, yeah, so I again, similarly, I may not owe for this? This is a dispute between others?

That's correct. Those denied days are the hospital's responsibility, not yours.

If the hospital sends you a bill for them anyway, just call us and we will take it up with them.

Does that clear things up for those days?

That's great news.

I'm glad that's a relief. Now, looking at your total for the stay, your only confirmed cost is the copay, which is $350.

The room difference we discussed is under review rather than something you owe today. Does that sound right to you?

That does, thank you so much for your help.

You're very welcome.

An Infinitus agent handles an inbound call to a health plan from a member facing a large hospital bill. The agent finds a private-room coding error, explains the member’s financial responsibility, and opens a billing review while on the call.

Thank you for calling Dr. [redacted] office, how can I direct your call?

Hello, this is Sam, your care coordinator [redacted]. I'm calling regarding some missing information needed to complete a patient's enrollment into [redacted].

Do you have a moment to assist?

Sure. Yeah, how can I help you today?

I appreciate that. I am calling to collect the missing birthdate for patient [redacted]. Would you be able to provide that for me?

Yes, just give me one second Sam, while I look up his record.

Take your time. I will stay on the line while you look that up.

Okay. I see his information here. His date of birth is [redacted].

Thank you. Just to make sure I have this exactly right, that is [redacted]. Is that correct?

That is correct.

Thank you for confirming. I have updated the record for [redacted]. That was all the information I needed.

Enrollment can now proceed, and you will receive a summary of benefits within twenty four to forty eight hours.

Before I let you go, could you please rate your experience with this call on a scale of one to five, with five being excellent?

Sorry to interrupt you Sam, but while I have you here on the phone, we actually submitted a prior authorization for a different patient. Her name is [redacted].

And we're trying to figure out where that is. Do you think you could look that up and just let me know what the status is there?

I can certainly look into that for you. To pull up [redacted] file, could you please provide her date of birth?

Sure. Um, [redacted].

I have that information for you. The prior authorization for [redacted] was approved yesterday afternoon, and the approval documentation was sent over to your main clinic fax line.

Is there anything else I can assist you with regarding [redacted] file or any other patients?

Oh, let me let me put you on a brief hold. Just give me one second.

No problem at all. I will stay on the line and wait for you to return.

Okay, I think we're good. In terms of rating, feel free to give yourself a five.

Thank you so much for that feedback, I really appreciate it. It was a pleasure speaking with you today. Goodbye!

An Infinitus agent calls a healthcare provider’s office to collect the missing date of birth holding up a patient’s support program enrollment, then handles a second question from the provider about another patient’s prior authorization without dropping the thread.

The problem isn’t the care – it’s everything surrounding it

Every year, millions of patients are waiting for care that already exists. The medication is approved. The specialist has availability. The support program is funded. But somewhere along the way, the process breaks down.

Maybe the authorization is stuck in a queue, the follow-up never happened, or no one called to make sure the patient actually stayed on therapy after the first fill.

This is a costly coordination problem. And it is solvable.

Built for healthcare,
not adapted for it

See the evidence

In healthcare, getting it wrong isn’t an option. Through our patent-pending technology, we enforce verbatim language where required and controlled responses from pre-approved knowledge bases.

The result is empathetic, clinically aware, and safe by design, without compromising on patient experience.

Every agent is continuously evaluated by a clinical team of trained doctors and nurses, across professionalism, empathy, information accuracy, privacy, and clinical safety. Before, during, and after every call.

A healthcare contact-center agent relaxing at her desk while reviewing a call on her phone

under-triage rate

5/5

empathy score

4.9/5

professionalism score

Results

What it looks like when coordination works

Infinitus’ functionality is improving our ability to serve patients more accurately and effectively. With each call, it becomes more accurate and efficient, demonstrating how AI can adapt to the unique complexities of healthcare.

– Todd Boyd, Senior Director, Patient Access & Reimbursement, Amgen