HEALTHCARE Services

Ensuring every connection matters

Delivering healthcare services that simplifies the complexity in healthcare, making it easier, more insightful, and less stressful

Connect with our experts

Our global team is ready to unlock your business potential. We transform complex challenges into strategic opportunities through strategic partnerships.

Challenges

Complex healthcare journeys demand seamless experiences

Healthcare journeys span across fragmented systems, channels and stakeholders; increasing complexity and raising expectations. Everise brings the most experienced healthcare experts together with the right tools, processes and empathy.

Disconnected Healthcare Experiences

Healthcare interactions span across members, patients, clinicians, payers and benefits managers; making it difficult to deliver seamless, consistent experiences from enrollment, billing, eligibility, verification and care coordination.

Variable Access and Service Demand

Demand for healthcare support fluctuates across programs, populations, and events, creating uneven access, unpredictable volumes, and challenges in maintaining timely, consistent service at scale.

Regulatory and Compliance Pressure

Healthcare organizations operate under strict regulatory oversight, requiring adherence to privacy, licensing, security, and documentation standards across every interaction, while remaining audit-ready at all times.

Sensitive and Critical Interactions

Healthcare connections involve sensitive information, urgent needs, and high-value decisions. This requires the most knowledgeable advocates to balance accuracy, compliance and human compassion.

Impact

Proven healthcare CX at scale

Our healthcare BPO services are grounded in long-standing experience, deep industry focus, and the ability to scale rapidly when demand surges. This foundation supports consistent, reliable service across complex healthcare environments.

Healthcare BPO experience

0 + Years

Delivering healthcare customer service and CX solutions

Healthcare outsourcing expertise

0 %

Of Everise operations support healthcare organizations

Proven scalability

0 %

Average growth for MA sales programs during AEP

Approach

End-to-end healthcare experience management

We deliver full-scale support across the entire healthcare ecosystem, serving members, patients, providers, PBMs, and pharma companies. Our healthcare-focused solutions enhance access, experience, and care across every touchpoint—from first interaction through ongoing support.

Payer solutions

Member services, eligibility, benefits, claims, and enrollment define payer operations under strict regulatory oversight. We tailor payer-specific delivery models that manage fluctuating demand, maintain compliance, and ensure positive member experiences.

Provider solutions

Patient access, scheduling, billing, referrals, and care coordination define non-clinical interactions across fragmented systems. We reduce friction from first contact through resolution while maintaining continuity across high-volume provider interactions.

PBM solutions

Refills, formulary inquiries, prior authorizations, and pharmacy coordination create high-volume, time-sensitive workflows. We help PBMs manage these interactions with speed and precision while maintaining accuracy, compliance, and turnaround at scale.

Life sciences solutions

Patient access, reimbursement, medical information, device support, digital health, and safety reporting define life sciences interactions across the product lifecycle. We deliver compliant Human+AI support accelerating therapy, adherence, and compliance.

Transform your customer experience

Discover how Everise delivers confidence through innovative, empathetic CX solutions that drive business growth.

Insights

The Latest in Healthcare CX

Expert perspectives on trends, innovation, and transformation in healthcare customer experience

5 min read

Exceptional Patient Experience Begins with the First Call: How to Elevate Early Touchpoints with AI

Early interactions such as calls, chats, and portal requests shape trust and satisfaction long before the clinical visit.

Insights

5 min read

Healthcare Licensing Done Right: How to Turn AEP Complexity into Strategic Advantage

Every fall, AEP (Annual Enrollment Period) arrives like clockwork, and with it comes chaos. It’s a high-stakes sprint to convert, retain, and serve millions of members. Behind the scenes, healthcare licensing is a foundational requirement that can become a barrier if not handled with speed, accuracy, and scale.

Insights

5 min read

How a Leading Healthcare Payer Achieved A Strong 4+ Star Performance By Improving Member Experience

A leading U.S. health insurance provider serving over 39 million members, employer groups, and businesses, offers high-touch support for both inbound and outbound calls to assist members with benefits, claims, and care coordination.

Insights

5 min read

Turning Challenges into Strategic Opportunities: What the Medicare Advantage Star Rating Lawsuits Mean for the Future

The Medicare Advantage Star Ratings system has long served as a benchmark for quality and performance. Today, it sits at the center of a legal storm. Major health insurers are suing the Centers for Medicare & Medicaid Services (CMS), claiming that recent changes to rating calculations were inconsistent and lacked transparency.