Elythea

Voice AI forManaged Care PlansLeading AI-native member outreach for Medicare and Medicaid operations. Concurrently reach 10,000+ members/hour with dynamic two-way conversations, warm transfers, and perfect data reporting.Schedule DemoLearn MoreSpecialized Solutions for Government HealthcareOur Voice AI platform is designed for the unique requirements of Medicare and Medicaid programs, ensuring compliance and improving member outcomes.Medicare AdvantageAutomated member engagement and quality programs for Medicare Advantage organizations.Welcome calls for new membersCAHPS survey automationMammogram and colonoscopy quality gap remindersPreventive care outreachAnnual wellness visit schedulingLearn MoreState Medicaid AgenciesComprehensive member outreach and work requirement compliance for state Medicaid programs.HR1 implementation supportWork requirement automationMember redetermination remindersBenefit explanation callsPolicy update notificationsLearn MoreMedicaid MCOsStreamlined healthcare management and member engagement for Medicaid managed care organizations.CAHPS survey administrationHealth Risk Assessments (HRAs)Redetermination remindersCare coordination callsMember satisfaction surveysLearn MoreCase StudyServing High-Risk Members of a Fortune 25 Managed Care PlanSee how Elythea's voice AI outreach was able to reach patients that would have been otherwise unreachable and close critical gaps.Engagement ResultsHigh-Risk, Rural BIPOC Population3.88x Higher(p<0.001)AIElythea(6 days)ManualFTE(2 months)National Medicaid MCOTripling Member Engagement in Under 2 WeeksA leading national Medicaid MCOs high-risk BIPOC population in a key market was served by Elythea to transform their member engagement strategy. The results exceeded all expectations.Engagement RateTripledImplementation6 DaysKey Achievements:Improved appointment scheduling versus care management and FTE outreach in a 20 times faster timelineCulturally-responsive AI communication in 10+ languagesReduced health disparities through targeted outreach⚡Scalable HIPAA-Compliant Voice AIReach 100% of your member populationthe same morningLong-form conversations with detailed data logging at unlimited scale. From hundreds to hundreds of thousands of members — all contacted simultaneously.Government ReadyMeeting federal and state security requirements with complete documentationNo IT LiftNo integration with legacy systems needed, just member listHIPAA and SOC 2 CompliantEnterprise-grade security and privacy controls --- AI Outbound Solutions for Medicare Advantage PlansSend your existing member list. Elythea reaches your population quickly, captures what you need, and delivers audit-ready documentation.HIPAA BAASOC 2 ComplianceAudit Ready InfrastructureBook a demoHow Elythea works1Member list inSend secure member list with no integrations required and no API access required.2AI outreach at scaleMixed SMS plus phone call campaigns spaced out over multiple days or weeks to avoid overwhelming members while using respectful messaging.3Capture and resolveCollect CAHPS surveys, schedule wellness visits, verify addresses, confirm member information, route to agents as needed.4Return evidenceDetailed member level reporting in simple Excel file, sent to plan within a week.Whitelabeled at plan levelTwo-way conversations presented as your plan brand at scale.Unlimited concurrent callsFrom hundreds to hundreds of thousands of members — all contacted simultaneously.Smart retry logicTime-of-day optimization, voicemail handling, and respectful retry cadence.A Low Lift Medicare PartnerElythea requires only a member list. We have no integration needed, being the lowest-lift vendor you will ever work with.No Integration RequiredStart with just a secure member file via SFTP. No APIs, no system changes.Platformless SolutionNo app, no portal. We reach members directly through outbound phone calls and SMS.Verizon9:41 AM100%MAMedicare Advantage PlanOnline • RCSHi Maria! This is your Medicare Advantage plan. We wanted to personally welcome you to your new benefits. Do you have a few minutes to chat?Jan 15, 9:41 AMWe wanted to personally welcome you and make sure you know about all your benefits!Jan 18, 2:15 PMWe want to make sure you understand all the benefits available to you. Can we walk you through some of them?Jan 21, 4:45 PMYes, thank you!Jan 22, 3:12 AMThanks for getting back! First, we wanted to make you aware that your plan actually offers you an OTC allowance card which...3:12 AMText MessageAWV ScheduledMultilingual EngagementOur AI-driven outreach process enables intelligent, custom-built conversation scripts tailored to your Medicare Advantage plan's needs.Customizable Actions in Real TimeConduct CAHPS surveys, and schedule annual wellness visits. Connect members to preferred providers. Quality gap reminders with intelligent appointments.Support for 15+ LanguagesLive TranslationAI detects member language preference and provides seamless real-time translation for member conversations.Spanish • Auto-DetectedLive Translation"Vemos que está desenrolándose de ABC Health y solo tenemos algunas preguntas rápidas."02:15Reach everyone in their languageAI-driven phone and SMS automation designed specifically for Medicare Advantage plans3.8xHigher engagement rate(P < 0.001)20+Languages supported99.8%Uptime guaranteeWelcome CallsHand us your script and we'll give your mandatory welcome and verification calls to all new members, at a fraction of the cost.Automated member onboarding and benefit explanation with warm handoffs.Health Risk AssessmentsConduct SDoH screening and required screenings (like depression screening) at scale, at any interval.Warm transfer or schedule high-risk patients with CMs.Disenrollment CallsProactive outreach to members considering disenrollment.Capture reasons and attempt retention with benefit reminders.Quality Gap RemindersReach members to close gaps that impact HEDIS, CAHPS, and STARS.Whether it's breast cancer screenings or colonoscopies.Pharmacy OutboundContact members who missed prescription pickups, send prescription reminders.Warm transfer patients to your plan's pharmacists.Care Management OutboundContact 100% of all members and schedule high-risk ones with your CMs.Your care managers wake up on Monday with 15 patients already booked into their calendar.Provider Directory VerificationContact all your providers in your directory and verify all information in <1 week.Monthly basis verification to maintain accuracy.CAHPS Survey AutomationRun CAHPS scripts and capture structured responses.Auto-schedule follow-up engagement for improved scores.Annual Wellness VisitsProactive member outreach for AWV scheduling.Risk stratification and care gap identification.Attempt policy and cadenceWe use smart retries, time-of-day optimization, and voicemail logic. Plans can configure attempt count and spacing by program.6+Guaranteed attemptsSix plus attempts per member when required.Outreach Timeline:Week 1Week 2Week 3Customizable data reportingReceive custom Excel file reports based on granular specifications.Examples:"Did member schedule AWV?""Summary of member CAHPS response"Elythea Solutions for Medicare AdvantageScalable outreachReach every member simultaneously with Voice AI technology.STAR ratings improvementCAHPS scores increase through consistent member engagement.Quality gap closureProactive reminders for preventive care and wellness visits.Real-time responsivenessInstant member support with intelligent call routing to live agents.Multilingual supportSupport for English, Spanish, and many more with interpreter routing.Audit-ready proofAttempts, outcomes, audio, transcripts, and metadata packaged per member.You send a secure member file. We reach everyone, improve STAR ratings, and return proof ready for auditors.Scale member outreach with an AI contact centerSend us a member list on Monday morning. Contact your population by Tuesday evening, in any language.Book a demoFrequently asked questionsHow does Elythea improve STAR ratings?Can Elythea handle CAHPS surveys and member satisfaction?Do we need to integrate our member management system?How does multilingual support work for Medicare members? --- Elythea makes H.R. 1 compliance operationalWe educate members, collect attestations, verify compliance, and produce evidence packets that satisfy H.R. 1 community engagement rules. Agencies provide a secure member file. Elythea handles the rest.Request a state demoNo IT lift. SFTP or S3. State data boundary available.H.R. 1 Requirements80 Hours/MonthDocumented community engagement required monthly30-Day Cure WindowNotice and cure period before disenrollmentNo Section 1115 WaiverRules cannot be waived under federal authority100% Member ReachEvery 90 days for compliance verificationFinancial ImpactAverage state Medicaid agencies risk losing $2.3B annually without scalable outreach infrastructureScalable HIPAA-Compliant Voice AIReach 100% of your member populationthe same morningLong-form conversations with detailed data logging at unlimited scale. From hundreds to hundreds of thousands of members — all contacted simultaneously.No IT LiftNo integration with legacy systems needed, just member listHIPAA CompliantEnterprise-grade security and privacy controlsAudit ReadyComplete documentation for every interactionSee the complete automation in actionA Low Lift State Medicaid PartnerElythea requires only a member list. We have no integration needed, being the lowest-lift vendor you will ever work with.No Integration RequiredStart with just a secure member file via SFTP. No APIs, no system changes.Direct Member OutreachNo app, no portal. We reach members directly through outbound phone calls and SMS.Verizon9:41 AM100%SMState Medicaid AgencyOnline • RCSHi Tyra! I am reaching out from your state Medicaid plan. It is time to verify your work or qualifying activities so your Medicaid coverage can continue. If you already did it, let me know, or tell me if I should stop reaching out.Jan 15, 9:41 AMJust checking in! If we don't get your verification by tomorrow, your coverage could stop. It only takes a few minutes.Jan 21, 4:45 PMI am so sorry, I am on the night shift. Yes, I can do it now.Jan 22, 2:03 AMNo worries at all! I am so happy you have some time now. Since you're working, how many hours did you work in the last 90 days?Jan 22, 2:03 AMMessageMultilingual EngagementOur AI-driven outreach process enables intelligent, custom-built conversation scripts tailored to your State Medicaid Agency's needs.Customizable Actions in Real TimeVerify work requirements, capture exemption information, and schedule follow-up calls with case managers. Route members to job training programs and community resources.Support for 15+ LanguagesLive TranslationConverse with members, fluently, in their native language over SMS texting and real-time phone calls with dynamic language switching.Verizon2:15 PM87%ABCABC State Medicaid PlanServicios para MiembrosEspañol • Auto-DetectadoTraducción en Vivo"Hola, María. Le llamo del programa Medicaid del estado de Ohio."02:15Reach everyone, in their language3.8xHigher engagement rate(P < 0.001)20+Languages supported24/7Responsive communicationWork requirement campaigns can scale to very large populations on short timelines.Multilingual engagement and interpreter routing with full audit trails.Attempt policy and cadenceSmart retries, time-of-day optimization, and voicemail logic for work requirement verification. State agencies can configure attempt count and spacing by program.6+Guaranteed attemptsSix plus attempts per member when required for compliance.Verification Timeline:Day 1Day 3Day 7Day 10Day 15Day 20Customizable data reportingReceive custom Excel file reports based on granular state specifications.Examples:"Did member report job training program?""Summary of member work activities and hours"Elythea is an AI-native BPOVoice AI, data verification, and audit-grade documentation at statewide scaleVoice AIOutbound calls to the full population with smart retries and optimizationMultilingual flows with interpreter routing and TTY compatibilityDynamic scripts that capture attestations with timestampsVerificationEx parte checks using reliable state and partner dataAutomated exception handling for exempt groupsDocumentationPer-member evidence packets with audio and transcriptsCampaign-level compliance binders with checksumsSecurity & AccessHIPAA safeguards and BAARole-based access and state data boundary optionYou send a secure member file. We reach everyone, verify compliance, and return proof ready for auditors.Frequently asked questionsDo we need to integrate our eligibility system?Can Elythea handle 80-hour attestations and verification?What happens when someone does not respond? --- AI Outbound Solutions for Medicaid MCOsSend your existing member list. Elythea reaches your population quickly, captures what you need, and delivers audit-ready documentation.HIPAA BAASOC 2 ComplianceAudit Ready InfrastructureBook a demoA Low Lift Medicaid PartnerElythea requires only a member list. We have no integration needed, being the lowest-lift vendor you will ever work with.No Integration RequiredStart with just a secure member file via SFTP. No APIs, no system changes.Platformless SolutionNo app, no portal. We reach members directly through outbound phone calls and SMS.Verizon9:41 AM100%ABCABC Health PlanOnline • RCSHi Maria! This is ABC Health Plan. We'd like to help you complete your Health Risk Assessment. Do you have a few minutes to chat? You can always let me know to stop messaging you if you're not interested.Jan 15, 9:41 AMHey, just following up in case you missed this!Jan 18, 2:15 PMI hope everything is okay, whenever you get the chance can you please shoot me a text?Jan 21, 4:45 PMSorry, been so busy! Yes I can do this nowJan 22, 3:12 AMPerfect! The assessment takes about 10 minutes. Based on your responses, we can connect you with our care team.3:12 AMGreat! Let's get started.3:13 AMText MessageHRA CompletedMultilingual EngagementOur AI-driven outreach process enables intelligent, custom-built conversation scripts tailored to your Plans' needs.Customizable Actions in Real TimeConduct an HRA, and schedule all high-risk members in a care manager's calendar. Connect members to the nearest food bank. Quality Gap reminders with intelligent appointments.Support for 15+ LanguagesLive TranslationConverse with members, fluently, in their native language over SMS texting and real-time phone calls with dynamic language switching.Verizon2:15 PM87%ABCABC Health PlanMember ServicesSpanish • Auto-DetectedLive Translation"Hola Carlos, estoy llamando de ABC Health Plan para ayudarte con tu evaluación de riesgo de salud."02:15Auto-Detected SpanishHow Elythea works1Member list inSFTP or S3. We map to your dictionary. No APIs required.2AI outreach at scaleMixed SMS plus phone call campaigns spaced out over multiple days or weeks to avoid overwhelming members while using respectful messaging to avoid spamming.3Capture and resolveCollect HRAs, schedule visits, verify addresses, confirm eligibility fields, route to agents as needed.4Return evidenceDetailed member level reporting in simple Excel file, sent to plan within a week.Whitelabeled at plan levelTwo-way conversations presented as your plan brand at scale.Truly human-soundingVoice AI built to feel natural in calls and texts.Audit-ready proofAttempts, outcomes, audio, transcripts, and metadata packaged per member.Reach everyone in their languageAI-driven phone and SMS automation designed specifically for Medicaid Managed Care Organizations3.8xHigher engagement rate(P < 0.001)20+Languages supported99.8%Uptime guaranteeQuality Gap RemindersReach members to close gaps that impact HEDIS and quality measures.Whether it's breast cancer screenings or colonoscopies.Health Risk AssessmentsConduct SDoH screening and required screenings (like depression screening) at scale, at any interval.Warm transfer or schedule high-risk patients with CMs.CAHPS SurveysConduct member satisfaction surveys at scale to boost your CAHPS scores.Capture feedback and sentiment analysis for quality improvement.Redetermination RemindersProactive outreach to members approaching redetermination deadlines.Help members maintain coverage with document submission reminders and renewal assistance.Pharmacy OutboundContact members who missed prescription pickups, send prescription reminders.Warm transfer patients to your plan's pharmacists.Care Management OutboundContact 100% of all members and schedule high-risk ones with your CMs.Your care managers wake up on Monday with 15 patients already booked into their calendar.Provider Directory VerificationContact all your providers in your directory and verify all information in <1 week.Monthly basis verification to maintain accuracy.Maternal ProgramsPrenatal and postpartum visit outreach.Transportation and social resource navigation.Preventive Care VisitsProactive member outreach for preventive care scheduling.Risk stratification and care gap identification.Attempt policy and cadenceWe use smart retries, time-of-day optimization, and voicemail logic. Plans can configure attempt count and spacing by program.6+Guaranteed attemptsSix plus attempts per member when required.Outreach Timeline:Week 1Week 2Week 3Customizable data reportingReceive custom Excel file reports based on granular specifications.Examples:"Did member mention housing instability?""Summary of member care gap status"Elythea Solutions for Medicaid Managed Care OrganizationsScalable outreachReach every member simultaneously with Voice AI technology.HEDIS measure improvementImprove quality measures through consistent member engagement.Quality gap closureProactive reminders for preventive care and wellness visits.Real-time responsivenessInstant member support with intelligent call routing to live agents.Multilingual supportSupport for English, Spanish, and many more with interpreter routing.Audit-ready proofAttempts, outcomes, audio, transcripts, and metadata packaged per member.Scale member outreach with an AI contact centerSend us a member list on Monday morning. Contact your population by Tuesday evening, in any language.Book a demoFrequently asked questionsDo we need to integrate our systems before launch?Will members think this is a bot?How many attempts do you make?How do you handle language access?Security & PrivacyHIPAA aligned controls and BAAComprehensive privacy controls with Business Associate Agreement.Role-based access with redactionGranular access controls and automatic data redaction.Encryption in transit and at restEnd-to-end encryption for all data handling and storage.Per-plan data boundary optionDedicated infrastructure options for enhanced isolation.