How a payer call runs
From one request to a structured answer, with your biller on the line only when a person is needed.
Payer calls in the docs →- Step 1Start the call
- One request names the payer, the call type and the claim, member or provider it is about. A rule can start it too, such as a call every 5 days until a pending claim moves.
- Step 2Daybook works the phone tree
- It reads the menu, enters the ids the IVR asks for and follows your call script where you have one. A new payer's tree is mapped once and saved, so later calls go straight to the right option.
- Step 3Hold
- Daybook waits. Your system hears how long the hold has run, and nobody on your team listens to the music.
- Step 4A rep picks up
- A voice agent asks the questions itself, or a dialer rings your biller in with the questions ready. Either way the call follows the rules and scripts from your own knowledge base.
- Step 5A structured answer
- The status, the reference number, the rep's name and the next step come back as fields, written onto the claim and sent to your system as a signed webhook.
For medical billers
Your billers spend their day on hold. Daybook takes the call types that fill an AR desk, claim status, eligibility, prior auth, appeal status and payment trace, and brings each answer back as data your team can act on. Your billers keep every decision.
- Claim status, eligibility, prior auth, appeal status and payment trace calls, handled end to end
- An appeal status call that returns received, in review, overturned or upheld, with the case number, the decision and the next level and its deadline
- A payment trace call that gets the check or EFT number, amount and date for a claim marked paid
- A silent claim escalated from a 276 to a call, under your own rules
More for medical billers: the billers page and claim status automation for billing companies.
For dental billers
Some dental payers answer only by phone. Daybook makes those calls for the offices you bill for, asks where a claim stands or whether a patient is covered, and puts the answer and the call reference number on the claim. Your biller decides what happens next.
- Claim status by phone when the clearinghouse answer is not enough
- An eligibility call that confirms coverage, the plan, its dates and network status, and records the copay, coinsurance, deductible and out-of-pocket amounts
- A payer's phone tree mapped once, so the next call to that payer goes straight to the right option
- The call reference number kept with every answer
More for dental billers: the dental page.
Starts from your knowledge base
Your billing company's own rules, appeal workflows, payer quirks and call scripts are what Daybook runs. You send the documents, Daybook imports them as payer guides, shows you what it produces, and you adjust it together on a call. Each solution runs on its own, so you start with one and add the next.
For payer calls that is what you would teach a new biller before their first call to each payer.
- Your call scripts, followed as written
- Each payer's phone tree, mapped once and kept
- The questions your biller asks on each call type
- Your rule for when a quiet claim becomes a call
Where it shows up
- The claim in your PM or EHR
- The status, the reference number, the rep's name and the next step, as fields
- A signed webhook
- call.on_hold, call.handoff_ready and call.completed
- The Daybook dashboard
- The call and its answer on the worklist
Start a call from your own system
One request starts the call. Signed webhooks bring back the hold, the hand-off and the answer, and the same operation is an MCP tool for your own agents.
Read payer calls in the docs →Frequently asked questions
What billing teams ask us about payer calls, and our answers.
How do the payer calls work?
You can have a dialer wait on hold and hand the call to your biller once a rep is on the line, or have a voice agent handle the whole call. Either way the call follows the rules and scripts from your own knowledge base.
Which calls can Daybook make?
Claim status, eligibility, prior authorization, appeal status and payment trace calls, end to end. Every answer comes back as fields: the status, the reference number, the rep's name and the next step.
How does Daybook learn a payer's phone tree?
A payer's tree is mapped once and saved. Later calls to that payer go straight to the right option.
Does a person ever need to join the call?
Only when you want one to. With the hand-off, Daybook waits on hold and rings your biller in when a rep picks up, with the questions ready. Otherwise the voice agent handles the call itself and your biller reads the answer.
Can a call repeat until a claim moves?
Yes. A call can run on a schedule, such as every 5 days until a pending claim changes status, and stops when it does.
Does Daybook change anything on the claim?
No. Daybook writes what the payer said onto the claim and does not change the claim on its own. Your billers decide every appeal, write-off and resubmission.