Why per-call is the right unit
Provider calls are transactional. A provider office wants to know whether a member is eligible, what the copay and deductible are, or where a claim stands. Each call has a beginning and an end, so the cleanest way to compare options is the fully loaded cost of one handled call.
Per-minute pricing and per-seat pricing both hide that number. Per-minute rewards rushing a caller off the line. Per-seat charges you for empty chairs in quiet months and leaves you short during open enrollment.
What goes into an in-house call
The wage of the person on the phone is only part of it. A realistic per-call cost for an in-house team also carries:
- Loaded labor: benefits, payroll taxes, and supervision on top of the hourly rate.
- Idle and wrap time: the minutes between calls and after them, which you pay for whether the phone rings or not.
- Turnover and training: every new hire takes weeks to learn plan designs and systems.
- Callbacks and rework: a wrong answer on the first call becomes a second and third call.
- Seats and telephony: licenses, hardware, space, and the contact center platform.
- Coverage gaps: calls that arrive after hours or on weekends go to voicemail and come back as callbacks.
Put together, that is why in-house provider calls commonly land between $6 and $12 each. Offshore BPOs reduce the labor line, typically to $2 to $5 per call, but keep the queue, the hours, and the training burden.
A worked example
Take a TPA receiving 13,500 provider calls a month, the volume in our Acuity Group case study. The figures below are illustrative, using the midpoints of the ranges above.
| Handling | Cost per call | Monthly cost at 13,500 calls |
|---|---|---|
| In-house representatives | $9 (midpoint of $6–$12) | $121,500 |
| Offshore BPO | $3.50 (midpoint of $2–$5) | $47,250 |
| EHVAhealth | From 50¢ | From $6,750 |
Two caveats keep the comparison honest. First, your EHVAhealth rate depends on volume, the call types in scope, and the complexity of your systems, and it is quoted in writing after one scoping call. Second, not every call is automated: in the Acuity deployment, 81% of in-scope calls were handled without staff and 19% were escalated to people. Your team still handles those, but they are the calls that need judgment rather than a lookup.
What is included in the per-call rate
With EHVAhealth, onboarding, integration with your admin platform, script design, testing, and go-live are part of the per-call rate, not a separate implementation invoice. Every call is QA-scored. Long calls do not cost more, because pricing is per call rather than per minute, and misdials and immediate hang-ups are not billed.