Side by side
| In-house staff | Offshore BPO | Voice AI (EHVAhealth) | |
|---|---|---|---|
| Typical cost per call | $6–$12 | $2–$5 | From 50¢ |
| Time to answer | Queue dependent | Queue dependent | Under 1 second |
| Hours | Business hours | Extended | 24/7, every day |
| Volume spikes | Hire and train | Renegotiate seats | Absorbed, rate holds |
| Quality review | Sampled | Sampled | Every call scored |
| Knowledge of your plans | Trained, lost with turnover | Trained, lost with turnover | Read from your systems and plan documents |
Where in-house staff still win
Complex member situations, appeals, sensitive conversations, and anything that needs a judgment call belong with people who know your plans and your clients. The goal is not to remove your team. It is to stop spending their day on calls that are lookups.
Where a BPO falls short
An offshore BPO lowers the labor cost but keeps everything else: a queue, limited hours, training on every plan design, and turnover that resets that training. Quality is sampled, so most calls are never reviewed.
Where voice AI fits
Voice AI is strongest on high-volume, repetitive provider calls: eligibility, benefits and accumulators, and claims status. It answers on the first ring, reads the same systems your representatives use, and hands the call to your team with context when a person is needed. In production, Acuity Group handled 81% of in-scope calls this way and CareFactor 90%.
The mix most TPAs land on
- Voice AI answers routine provider calls around the clock.
- Your team takes escalations, with the conversation attached, plus member calls and anything that needs judgment.
- Volume spikes like open enrollment are absorbed without hiring or a queue.