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Patient access, trained for healthcare's hardest patient populations

Healthcare-trained patient access operation engineered for provider networks, clinics, and payviders serving patient populations where the call is the first decision point of care.
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4.9M+

Patient access calls vetted for a single engagement - clinical staff stayed off the phones

+15 pts

Outperformed the client's in-house team on patient conversion within 90 days of launch

100%

Quality goal attainment, every quarter of 2025, on a workflow with no margin for error

60 days

Signature to production-ready across your full network footprint

Patient access isn't a call center. For the populations you serve, the call is the front door of care.

A patient calling to reschedule a dialysis appointment they can’t safely skip. A patient deciding today is the day to enter substance use treatment. A patient navigating fertility coverage in the middle of an active cycle. A caregiver asking a question that’s blocking the next visit. In chronic care, behavioral health, fertility, and the long tail of subspecialties, the phone is where the decision to seek care actually happens, or where it falls apart.

Generic call center models – optimized for handle time and transfer rate – lose these patients before they reach the chair. We build patient access as a specialty operation: trained, stable, measured, and engineered for the patient population your business actually serves. Operational excellence is what makes the patient experience possible. The patient experience is what makes the operation worth investing in.

What changes when patient access is built for the hardest versions of the work

For the operator

Clinical staff stay on the floor. Every location runs on the same call guide. Missed appointments and mishandled escalations stop being regular incidents.

For the sponsor

Portfolio-level standardization on a function that's visible in diligence. Predictable cost structure. Tail risk priced out instead of carried.

For the payvider

The seam between scheduling intent and revenue capture stops leaking. Member experience and patient experience become a single, governable operation.

For the patient

The call gets answered. The agent understands their context. If the call needs more than a routing decision, the response is trained and protocol-driven, not improvised.

Lloyd Fernandes, Practice Director, Everest Group.

As healthcare CXM evolves toward outcome-driven, technology-enabled operations, service providers must demonstrate the ability to integrate domain expertise with scalable digital capabilities. This is driving a shift toward models that embed analytics, and AI, to improve employee performance and member/patient experience outcomes. ResultsCX is well positioned to meet buyer needs through its broad healthcare value chain coverage, strong payer-centric and growing provider portfolio, and diversified global delivery model. Its investments in proprietary solutions such as SupportPredict™ and SupportPredict GENius™, along with capabilities in conversational analytics, real-time agent assist, and AI-driven training, have enabled more efficient and insight-led operations. These factors have contributed to its positioning as a Leader in Everest Group’s Healthcare CXM Intelligent Operations PEAK Matrix® Assessment 2026.

Healthcare CXM Intelligent Operations PEAK Matrix

Three audiences. One operation. Same proof points.

Provider networks, clinics, and payviders are solving the same problem from different seats. We serve all three, with the same centralized patient access operation, sized and scoped to the seat you sit in.

Provider Networks

Your front desk is a clinical resource. Stop using it as a phone line.

Hospital systems, multi-site provider organizations, and specialty practice groups inherit fragmented patient access by default - every location running its own scheduling, its own answering line, its own SOPs - quietly leaking revenue.

One centralized operation

Across your full footprint. One number, one call guide, one accountable team

Specialty-capable agents

Trained for the patient populations you actually serve

EHR-integrated workflows

Athena, Epic, Dentrix, Eaglesoft, and others. Your clinical team never changes how they work

Clinical staff stay clinical

The phone work moves off the floor and onto a healthcare-trained team

PE-Backed Clinic Platforms

Your investment thesis demands operational efficiency. Your call centers are still 10 different numbers.

Every acquisition adds another scheduling team, another SOP binder, another inherited model. Margin contribution, revenue recovery, and exit-readiness all move with the same operation. Right now, it's probably carrying tail risk that isn't on the P&L.

Margin contribution you can forecast

40 - 60% cost reduction vs. onshore, moving with volume rather than locations

Revenue recovery

Every unanswered call is a missed appointment, a missed procedure, a direct hit to EBITDA

Tail risk priced out

A trained, stable, audit-ready operation across the portfolio

Exit-ready standardization

The function sourcing teams grade on, already documented

Payviders

You sit where intake intent becomes revenue capture. We close the seam.

Integrated care-and-coverage models live at the join between scheduling, eligibility, prior authorization, and member services. That's where the leakage happens, and where most BPO models stop. We don't stop there.

End-to-end front-of-funnel

Scheduling, eligibility verification, prior auth, member services. One team, one operation

Member experience that doesn't bifurcate

Patient-side and member-side calls handled by the same trained team

Revenue-cycle alignment

Intake captured with the context the billing operation actually needs downstream

Specialty workflow depth

Trained for the complex chronic and behavioral health populations payviders increasingly own

Three pain patterns. One root cause.

Across all three audiences, the same operational pain shows up in different shapes. The root cause is the same: patient access is treated as overhead, run by teams not built for the populations it serves.

Fragmented patient access operations

Multiple location-level or line-of-business-level call centers, with no centralized standard, no aggregated data, and no scalable capacity. For PE-backed platforms, it's the 5–20 inherited scheduling teams after rollup.

For provider networks, it's clinical staff absorbing phone work that should never have reached the floor. For payviders, it's scheduling and member services running as separate operations with no shared context.

Missed appointments = missed revenue

Every unanswered call is a lost appointment. For a specialty practice, that's a lost procedure. For a behavioral health center, it's a lost treatment start - a patient who decided today was the day and didn't get through.

For a payvider, it's a member who churned because they couldn't navigate the front door. The revenue impact is direct and quantifiable.

Patient-population risk you aren't pricing

For complex populations with chronic care, behavioral health, specialty fertility, oncology, vulnerable patient cohorts, a mishandled call becomes a regulatory inquiry, a payer complaint, a member-experience incident, an exit-diligence flag.

It's invisible on the P&L. It's visible at exit, in CAHPS scores, in escalation logs, and in the quality reviews PE sponsors increasingly ask for.

One centralized patient access operation engineered for complex populations.

We replace your fragmented, per-location, or per-line-of-business model with a single healthcare-trained operation: specialty-capable, EHR-integrated, governed end-to-end, and designed to scale with your footprint. We integrate with your EHR or practice management platform (Athena, Epic, Dentrix, Eaglesoft, and others) so your clinical team never has to change how they work.

 

“For every appointment scheduled, that is revenue in the door for a provider. It’s an appointment, it’s a customer, it’s money. And for the patients who matter most, the call is often the first decision point of care.”

Three core capabilities

01

Patient Registration & Appointment Scheduling

The front door. Demographic capture, financial and insurance information, appointment booking, recall scheduling, no-show reduction workflows.


For patients calling at the moment they’ve decided to seek care, and for the ones calling because they need to reschedule treatment they can’t safely skip.

 
02

Eligibility & Benefits Verification

The handoff that protects revenue. Outbound calls to health plans to confirm coverage, deductibles, copays, and coinsurance before patient appointments, plus the back-and-forth that catches issues before they become denials. Closes the loop between scheduling intent and revenue capture.

 
03

Prior Authorization

The work that gets routinely deprioritized, and that costs real money when it slips. We manage prior auth submissions, follow-ups with payers, and exception handling across specialty workflows. Documented, governed, and tracked.

Supporting capabilities

Patient Support & CX Services

Appointment reminders and confirmations, patient follow-up calls, recall scheduling, post-visit touchpoints, and new patient acquisition support, the continuity-of-care layer that sits underneath the core capabilities.

Analytics, Automation & Platforms

Our proprietary tech stack with GENius (agent assist), CallMiner (speech analytics), automation layers, and AI-augmented routing, sits on top of the patient access operation. The platforms compound the operational discipline; the operation is what makes the platforms credible.

Where we win against the alternatives.

Generic BPOs, answering services, and per-location in-house teams aren’t built for the complex-population or multi-segment patient access model. We are.

01

Healthcare-only specialization

Our agents are trained on HIPAA, EHR workflows, the language of specialty medicine, and the protocol discipline that turns generic call handling into specialty patient access.

 
02

Engineered for the hardest versions of patient access

We build the operation for the populations that break generic call centers, the long tail of subspecialties where the call is the conversion event. The skill set translates down; the reverse isn’t true.

 
03

PE-grade economics

40 – 60% below onshore in-house blended cost, scaling with volume rather than with locations. The business case writes itself; the investor story improves with it.

 
04

Built to grow with your footprint

We’re designed to scale as you add locations, lines of business, or acquired practices not renegotiated at every milestone. Add a site, add capacity. That’s the model.

 
05

Low-risk entry model

Start with one location, one service line, or one specialty. Prove the model in 60 days, then expand. No multi-year commitment required to get in the water.

 
06

Everest PEAK Matrix Leader

Named a Leader in the Everest Health Intelligent Operations PEAK Matrix, the credibility benchmark PE-driven sourcing teams and operating partners actually use.

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