Infinitus Systems
Voice AI that automates the payer phone call, which is the specific administrative bottleneck almost no other AI vendor attacks directly. The agent dials insurance companies, navigates IVR menus, waits on hold, and completes benefit verifications, prior authorization checks, claim status inquiries, EOB retrieval and appeals, then writes structured results back to the provider system. Founded 2019 in San Francisco by former Google engineers Ankit Jain and Shyam Rajagopalan, with investors including Google Ventures and Kleiner Perkins and a $51.5 million Series C in October 2024. The technical asset worth understanding is a knowledge graph of payer-specific rules, so the agent knows which questions to ask each individual insurer rather than following a generic script, which is what makes automated payer calls tractable at all given every payer runs a different phone tree and asks for different information. Anything ambiguous routes to a human reviewer before finalisation. The company reports handling millions of calls across pharmaceutical, provider and digital health customers, states it powers payer-facing conversations for 44 percent of the Fortune 50, and cites reach across 125,000 providers. The platform has broadened considerably through 2025 and 2026: an agentic AI suite for health plan member services in February 2026, Infinitus Studio, a healthcare-specific no-code AI agent builder, in April 2026, and Lens, a conversation-review engine for both AI-led and human-led interactions, in May 2026, alongside a healthcare-focused MCP server for agent interoperability and expanded Salesforce integration across Health Cloud, Life Sciences Cloud and Agentforce. Holds HIPAA and SOC 2 attestations. Positioned deliberately as a phone automation and agent layer inside the access stack rather than as an ePA network, hub administrator or case management platform.
Capability Axes
The agent is the product and there is no plausible non-AI version. Automating a payer phone call requires speech recognition, IVR navigation, real-time dialogue with a human agent, and structured extraction from an unstructured conversation. The knowledge graph of payer-specific rules is a substantive proprietary asset rather than a scripted decision tree, since it encodes which questions each individual insurer requires. Critically there is no offshore call centre underneath, which is exactly what separates this from the outsourced verification services it displaces.
Genuinely autonomous on the task, with a disclosed human boundary. The agent independently dials, navigates IVR, holds, converses and extracts structured data, but anything AMBIGUOUS routes to a human reviewer before the result is finalised. That is a clearly stated escalation rule rather than a vague human-in-the-loop assurance, and it places the human at the point of uncertainty rather than as a blanket review of everything. The company describes safety-first AI with robust human and technology guardrails and a healthcare-specific guardrail architecture launched April 2025. The Lens conversation-review engine, covering both AI-led and human-led interactions, adds a retrospective audit layer, which is the natural complement to real-time escalation.
The architecture is described more concretely than most: a knowledge graph of payer-specific rules driving question selection, a patented architecture that routes tasks to the most performant available model rather than committing to one, and named components including the Eva agent and FastTrack copilot. Model-agnostic routing is an honest design disclosure. Graded B rather than A because no accuracy figures with stated methodology were located, and the frequently cited 50 percent ROI and cost-per-claim improvements are vendor or directory figures without disclosed measurement basis.
Not a clinical product, so this reads as operational evidence, and it is all vendor generated. Millions of calls handled, 44 percent of the Fortune 50, 125,000 providers and a typical 50 percent ROI are scale and outcome claims with no independent audit, named customer result or disclosed methodology. Third party directories note limited public user reviews because enterprise customers rarely post to G2 or Capterra, so independent corroboration is genuinely scarce rather than merely absent. Same standard applied to Candid Health and QuantHealth: specific numbers without methodology remain vendor claims.
HIPAA and SOC 2 attestations held, and the guardrail architecture is healthcare-specific by design with the company stating conversations stay fully compliant. The PHI surface here is distinctive and worth naming: the agent discloses patient identifiers to payer representatives over the phone in order to complete verification, so the risk is not only data at rest but what the agent says aloud and to whom. The ambiguity-escalation rule and the Lens review engine both address that. Graded B rather than A because no published retention policy for call recordings or transcripts was located, and no statement on whether call data trains models.
HIPAA attestation reported by independent third party review alongside SOC 2. Graded B rather than A because no BAA terms or execution process were located in published form.
SOC 2 attestation confirmed by independent third party review rather than vendor claim alone. Graded B rather than A because the located sources do not specify Type I versus Type II, which is the distinction that carries weight, and no trust center or downloadable report was identified. Buyers should require the report itself.
Not an FDA regulated product. Payer phone automation, benefit verification and prior authorization workflows sit entirely outside Software as a Medical Device. The relevant regulatory surface is HIPAA, state call recording and consent law given the agent records payer conversations across jurisdictions, and payer contract compliance.
No governance framework, subgroup analysis or bias evaluation located. The guardrail architecture addresses compliance and accuracy rather than equity. Two exposures worth naming that are specific to this product class: the agent must be understood by human payer representatives across regional accents and call quality, and separately, an unresolved disclosure question is whether payer representatives are told they are speaking with an AI agent, which located materials do not address. That is a transparency issue with regulatory implications in several states, not merely an ethical preference.
Strong and deliberately built as infrastructure. Call outcomes are converted into structured data written back into downstream provider, payer, hub, specialty pharmacy and manufacturer workflows, which is the whole point since an unstructured phone result has no operational value. Salesforce integration spans Health Cloud, Life Sciences Cloud, Agentforce and MuleSoft-connected workflows. The company also launched a healthcare-focused MCP server in September 2025 for AI agent interoperability, which is an unusually forward interoperability move, and Infinitus Studio provides a no-code builder so customers can compose their own agents. Same infrastructure-to-build-on posture that earned CertifyOS and Candid Health an A.
Cloud platform by implication given the call automation model, but no hosting architecture, deployment option or data residency disclosure was located at the time of review.
No pricing published. Third party directories state pricing is custom, enterprise-focused, and scoped to deployment size, call volume and workflows automated. The enterprise orientation carries acknowledged access consequences, with independent review noting longer sales cycles and higher contract minimums that make the platform less accessible to mid-market practices and smaller billing companies. So the buyer profile is narrower than the problem it solves, which affects many organisations too small to purchase it.
Unusually broad across both workflow types and customer classes. Call types span benefit verification, prior authorization follow-up, claim status, EOB retrieval, appeals, formulary exception follow-up, provider directory verification and missing documentation collection. Customer classes span providers, payers, pharmaceutical manufacturers, biotech, specialty pharmacies and digital health, and 2026 expansion added health plan member services. The platform materials now cover access, affordability, adherence, patient, provider and payer workflows. Serving both sides of the payer-provider phone call is a wider footprint than any other RCM vendor in this index.
Pricing
Vendor-published figures are labeled as such. Figures labeled “Estimated” are derived from third-party sources and have not been confirmed by the vendor.
| Entry Price | Pricing Basis | BAA Tier | Implementation | Source |
|---|---|---|---|---|
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Not published
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Undisclosed. Custom enterprise contracts scoped to call volume and workflows automated. | — | — | Third Party Estimated |
No pricing published. Third party directories consistently report custom enterprise contracts scoped to deployment size, call volume and which workflows are automated, with no public rate card. The access consequence is real and independently noted: enterprise orientation implies longer sales cycles and higher contract minimums, making the platform less accessible to mid-market practices and smaller billing companies. That is a meaningful gap, because the payer phone call burden falls hardest on smaller organisations least able to absorb it and least able to afford enterprise contracting. The natural pricing unit here is per completed call or per successful verification, which would align vendor and customer incentives cleanly, but the company does not confirm its basis publicly. Buyers should establish whether pricing is per call attempted or per call successfully completed, since the difference matters when payer phone systems fail or queues are abandoned, and should clarify how calls routed to human review for ambiguity are billed. Also worth establishing what happens to the accumulated payer-rules knowledge specific to a customer's plan mix if the relationship ends. Commonly cited figures of roughly 50 percent ROI, up to 50 percent reduction in cost per claim worked and 15 percent increase in collections on denied claims originate from vendor and directory sources without disclosed methodology and should be treated as claims rather than benchmarks.