Transform Medicare Contact Centers with AI
Automatically capture enrollment decisions, verify Medicare IDs, ensure CMS compliance, and extract clinical and benefit details directly from conversations.
Built to support Medicare-focused processes, comply with CMS regulations, and handle the unique needs of senior care.
What Medicare calls analytics should capture
Medicare contact centers need specialized call analytics to extract enrollment status, identifiers, clinical notes, medication lists, and compliance documentation. This enables accurate enrollments, faster processing, and improved member outcomes.
CMS Compliance
Automatic compliance scoring and CMS rule adherence tracking
Medicare ID Verification
Automated extraction and verification of Medicare identifiers
Clinical Notes
Automatic capture of health conditions and medication lists
Enrollment Decisions
Real-time capture of enrollment choices and member consent
Sample Call Summary (auto-extracted)
See how our AI automatically extracts critical Medicare enrollment data.
Call Metrics
Performance Analysis
Key Strengths
Areas for Improvement
Doctors Mentioned
Health Conditions Discussed
Medications Extracted
| Name | Dosage | Frequency |
|---|---|---|
| Rosuvastatin | 40 mg | Not Provided |
| Levothyroxine | 88 mg | Not Provided |
| Gabapentin | 300 mg | Not Provided |
| Lansoprazole | Not Provided | Not Provided |
| Duloxetine | 30 mg | Not Provided |
| Meloxicam | 15 mg | Not Provided |
| Tramadol | 50 mg | Not Provided |
| Indapamide | 1.25 mg | Not Provided |
| Ezetimibe | 10 mg | Not Provided |
Actionable Insights
Auto-posting Targets
CRM field mapping is available for the following details:
Compliance Categories (detailed)
Each call is assessed against multiple compliance checkpoints, with scores reflecting how thoroughly the agent met each requirement.
| Category | Score | Status |
|---|---|---|
| Initial Disclaimer | 40/40 | Good (100%) |
| Healthcare Decision Making | 10/10 | Good (100%) |
| Permission to Access CMS/Medicaid | 10/10 | Good (100%) |
| Scope of Appointment Disclaimer | 55/55 | Good (100%) |
| Verification of Doctors | 10/25 | Attention (40%) |
| Verification of Prescription Meds | 10/40 | Attention (25%) |
| Summary of Benefits | 0/30 | Attention (0%) |
| Pre-Enrollment Script | 185/195 | Good (95%) |
| Application Process | 15/30 | Partial (50%) |
| Outro | 5/5 | Good (100%) |
| Outro Script | 80/150 | Partial (53%) |
Coaching Categories
| Category | Score | Status |
|---|---|---|
| Intro | 30/35 | Good (86%) |
| Probing | 10/20 | Needs work (50%) |
| Hospital Indemnity | 0/10 | Improvement needed (0%) |
| Outro Script | 20/20 | Good (100%) |
| HRA | 0/0 | No data |
| Final Expense | 0/0 | No data |
| Dental | 0/0 | No data |
Coaching Notes
Quality Score & Agent Performance
Quality Score
Agent Performance Scoring
Agent Scoring Highlights individual performance metrics from calls, providing insights to drive productivity improvements and targeted coaching opportunities
Balanced with thorough explanations
Strong ability to resolve without escalation
Demonstrates care and understanding
Follows CMS and internal guidelines closely
Consistently high ratings from members
Medicare KPI Improvements
Measurable improvements from Medicare contact centers using Verbix.ai
Frequently Asked Questions
All data is encrypted, access-controlled, and handled in compliance with healthcare privacy regulations.
Absolutely. We integrate seamlessly with EMRs and claims systems to deliver structured data where you need it.
Our AI delivers high accuracy, with performance improving as it learns from your use cases. Human-in-the-loop review can be added if needed.
Verbix.ai supports multiple languages, including English, Spanish, Hindi, Gujarati, Arabic, Portuguese, and Chinese, with more languages being added regularly.