Healthcare Customer Experience Outsourcing That Understands Compliance
HIPAA-trained agents handling patient communications, prior authorizations, billing inquiries, and member services — operating within your secured infrastructure with BAAs signed where required.
Bogotá-Based · EST-Aligned · Native Spanish + English
Healthcare CX Has a Compliance Problem and a Volume Problem
Patient call volumes are up. Prior authorization workflows are getting more complex. Your front desk and member services teams are burning out on repetitive work that AI could handle — but you can't put generic offshore agents on a HIPAA-bound conversation, and you can't afford the $58-75K loaded cost of US-based hires. Most healthcare organizations choose between speed and compliance. ArgusCX is built so you don't have to.
Healthcare BPO Services Built for Regulated Workflows
Our hybrid model layers AI on top of trained customer support outsourcing teams — built for the realities of healthcare workflows.
Patient Communications & Scheduling
Around-the-clock patient outreach paired with empathetic human handling for the moments that matter.
Manages appointment scheduling, confirmation reminders, intake form completion, and routine patient FAQ around the clock. Reduces no-shows through automated multi-channel outreach.
Appointment scheduling · Reminder workflows · Intake forms · Routine FAQ
Handles anxious patients, complex scheduling conflicts, escalations from family members, and any conversation requiring empathy or clinical context.
Anxious patient support · Family escalations · Schedule disputes · Clinical context handoffs
Prior Authorization & Insurance Verification
Automated eligibility and tracking with senior human agents owning appeals and payer negotiation.
Verifies insurance eligibility, tracks prior authorization status, auto-populates submission forms, and maintains real-time deadline dashboards.
Eligibility verification · Auth status tracking · Form submission · Deadline monitoring
Appeals denied authorizations, negotiates with payer representatives, manages peer-to-peer review coordination, and handles high-complexity cases requiring clinical justification.
Authorization appeals · Payer negotiation · Peer-to-peer coordination · Clinical justification
Medical Billing & Patient Financial Services
Self-serve billing support at scale, with humans on the line for disputes and hardship.
Answers routine billing inquiries, processes payments through secure portals, sends statement clarifications, and handles EOB explanation requests.
Billing FAQ · Payment processing · Statement clarification · EOB support
Resolves billing disputes, negotiates hardship payment plans, manages collections-sensitive conversations, and handles complex insurance coordination of benefits issues.
Billing disputes · Hardship plans · Collections-sensitive support · COB coordination
Member Services & Care Coordination
Intelligent routing and policy lookup, with care-trained agents owning sensitive member moments.
Routes member inquiries by topic and urgency, surfaces relevant policy information, schedules care coordination calls, and tracks engagement metrics.
Member inquiry routing · Policy lookup · Care coordination scheduling · Engagement tracking
Conducts care plan walkthroughs, manages care manager handoffs, supports members through diagnoses or new prescriptions, and handles plan benefit clarifications.
Care plan walkthroughs · Care manager handoffs · Member support · Benefit clarification
Why Healthcare Organizations Choose ArgusCX
HIPAA-Trained, Infrastructure-Flexible
Our agents are HIPAA-trained and operate within your secured infrastructure — your EHR, your portal, your secure messaging system. We sign BAAs where required and follow your access protocols, so compliance stays in your control while operational scale shifts to ours.
Bilingual at No Premium
65 million US Hispanic patients deserve native-Spanish support, not translated scripts. Our Bogotá-based agents handle English and Spanish conversations with cultural fluency — same team, same flat rate, no language surcharge.
EST-Aligned for Live Coordination
Colombia runs EST year-round with no daylight saving drift. Your clinical operations team in Boston, Chicago, or Houston gets a partner working the same hours — real-time escalation handling, same-day QA, live coordination on complex cases.
Built for Healthcare Sub-Verticals
Whether you're a multi-location practice group, a digital health platform, a telehealth provider, a DME company, or a revenue cycle management firm, we adapt our agent training and workflows to your specific clinical and operational context.
Compliance & Technology
See how our AI technology platform integrates with your existing healthcare stack.
Compliance Posture
- HIPAA-trained agents with documented training programs
- BAAs signed where required by client engagement
- Operate within client-secured infrastructure (your EHR, your portal, your access controls)
- Documented breach notification and incident response protocols
- Ley 1581 (Colombia data protection law) structurally aligned with GDPR
Technology Integration
- Plug into your existing EHR/EMR (Epic, Athena, eClinicalWorks, Cerner, custom systems)
- Salesforce Health Cloud trained
- Zendesk, Freshdesk, Intercom for non-clinical patient communications
- Twilio, Five9, Dialpad for voice and IVR
- Single sign-on through Okta or your existing IdP
Healthcare BPO FAQ
Ready to Talk About Healthcare CX?
Let's discuss what your patient communication, prior authorization, billing, or member services workflows look like — and how we'd structure a team to support them.
Book a Strategy Call