The member on a denied prior authorization. The patient waiting on a specialty refill. The provider disputing a claim edit. The veterinary practice reordering a temperature-controlled drug before close of business. These are the conversations that move CAHPS, Star Ratings, adherence rates, and account retention. Etech has run them for 22 years without a single breach.
What healthcare operators actually tell us
CAHPS and Star Ratings are board-level. OCR enforcement doubled 2022 to 2024. Adherence drives pharmacy P&L. Health plans and pharmacy operators do not need someone to answer calls. They need agents who protect the relationship, surface the risk, and hold the line on compliance.
Etech’s healthcare BPO services are built for operators who cannot afford generic outsourcing — every program is staffed with dedicated pods, scored against the client’s own CAHPS, Star Rating, or adherence targets, and covered by a 22-year breach-free compliance record.
Our CAHPS score moved the wrong direction. We traced 40 percent of the drag to two call reasons our sampled QA never flagged.
VP Member Experience, top-five U.S. health plan
Every point of agent churn shows up as a medication adherence point downstream. Tenure is a clinical outcome.
Director Patient Access, national specialty pharmacy
Our practice-facing volume doubles at quarter end and falls off in week two. A BPO floor idle forty percent of the year is not operational.
VP Commercial Operations, Fortune-10 pharmaceutical distributor
22 years in healthcare operations
We operate programs for Fortune-10 pharmaceutical distributors, top-five U.S. health plans, national specialty pharmacies, and the largest veterinary distributor in North America. The oldest agents on those programs have been on the account longer than most healthcare BPO executives have been in the category.
Where our healthcare programs live
Every program below is live today on a health plan, a specialty pharmacy, a pharmaceutical distributor, or a veterinary distributor. Agents are trained in the client's clinical, benefits, and operational systems. Scorecards are written to the client's CAHPS, Star Rating, adherence, or account-retention targets. Not ours.
Etech’s healthcare contact center outsourcing and medical call center outsourcing programs span payer, pharmacy, distribution, and veterinary verticals — covering inbound member support, outbound adherence, prior authorization, provider relations, wholesale order desks, and veterinary distribution under one HIPAA-compliant operating model.
Benefits and eligibility questions, formulary lookups, prior authorization status, appeals and grievances intake, ID card requests, plan comparisons during AEP and OEP. Staffed to CAHPS and plan-satisfaction targets, not average handle time.
Annual Election Period, Medicare Advantage, Part D, commercial open enrollment, Special Enrollment Period handling, LIS validation. CMS marketing-rule compliance enforced at script level. Seasonal surge capacity without opening new sites.
Refill coordination, refill-too-soon exception handling, adherence reminder outreach, MTM scheduling support. Directly tied to pharmacy P&L through PDC lift and Star Rating impact.
Benefits investigation, prior authorization initiation and follow-up, copay assistance and PAP enrollment, specialty pharmacy triage. The line where affordability friction becomes abandonment if it is not handled well.
Credentialing support, directory accuracy, claim disputes, coordination of benefits, appeals intake, network operations. Practice-facing work that drives provider NPS and contract renewals.
Prior authorization intake, clinical criteria capture, medical necessity documentation routing, voice-AI triage for routine cases, structured hand-off to the client's licensed clinical reviewers.
Wholesale and specialty order support, allocation questions, short-dated and backorder handling, authentication recovery, account management for pharmacies and infusion centers. Practice loyalty is the quiet metric here.
Vet-practice-facing order desks covering companion animal, livestock, and equine. Temperature-controlled logistics, DEA Schedule II and CSOS workflows, 58 states and provinces, peak-season scaling without hiring drag.
How we protect the people on the call
Most BPOs treat PHI redaction as a cleanup task after recordings land on disk. That model protects the vendor, not the patient. We built redaction into the ingestion stream. Protected data is removed before audio or transcripts touch Etech storage. The member is covered from the first word.
Protection at ingestion
Redaction runs in the stream. Unredacted audio never touches disk. Your BAA obligations downshift accordingly.
Trained on your data domain
Custom drug lists, plan identifiers, formulary entries, and account-specific entities added to the model for every new program.
Independently attested
PCI DSS 3.2.1 Level 1 certified. Redaction effectiveness verified by external audit. Annual reattestation.
What the redaction pipeline removes
Cardholder data across all payment workflows. PCI DSS 3.2.1 Level 1 certified on card-present and card-not-present.
Drug names, conditions, dosages, diagnoses, procedures, healthcare identifiers, blood type, and plan-specific entities trained per program.
Name, address, phone, SSN, DOB, email, and account identifiers. Redaction threshold tunable to the client's data-handling policy.
Independent attestation
“In a large-scale test conducted with an external auditing body, no exploitable information was retained after the redaction process.”
Outcomes our healthcare clients report
Every figure below is a client-reported outcome from an active payer, specialty pharmacy, distribution, or veterinary program. None of them are Etech self-assessments.
What compliance teams actually check
Every shortlisted BPO has a SOC 2 report. The seasoned compliance team looks next at the operating evidence: BAA flow-down across offshore subprocessors, OCR enforcement history, access-review cadence, and the subcontractor chain behind every touchpoint.
Twenty-two years of continuous healthcare operations. Zero OCR-reportable breaches. That is the number that answers the question. The certifications are the paperwork behind it.
Live attestations on trust.etechgs.comBAA in place on every account. Annual workforce training. Incident response tabletop tested quarterly. 22 years with no OCR-reportable breach.
Control framework in place across payer and specialty pharmacy programs. Aligns with the de facto evidence bar on most health plan RFPs.
Attested annually across all U.S., Jamaica, and India delivery centers. Unified control environment, not delivery-center-by-delivery-center.
Card-present and card-not-present workflows across copay, refill, infusion center, and veterinary wholesale transactions.
Schedule II controlled substance ordering support with diversion controls, allocation tracking, and chain-of-custody documentation.
State Medicaid variances, CMS Medicare Marketing Guidelines, Medicare Advantage Star measures, and NAIC producer licensing enforced in live scripts.
Continuity of care starts with continuity of agent
Every churned agent drops formulary recall, plan-design familiarity, and appeals-workflow muscle memory. It shows up in CAHPS, in Star Ratings, and in provider NPS. Retention is an operating decision, not a recruiting outcome.
Technology in service of the agent
Healthcare contact centers fail for a narrow reason. The agent cannot find the answer fast enough, or cannot navigate the plan design, the provider contract, or the prior authorization workflow. Our platform removes those failure points. It does not generate dashboards.
Scored against your rubric
Full-population QA. CAHPS-aligned scorecards. Not a generic checklist.
Real-time agent assist
Prior auth steps, appeals scripting, formulary exceptions surfaced in-call.
Healthcare-tuned speech
Drug names, diagnoses, procedure codes, veterinary pharma captured accurately.
Redaction at ingestion
Protected data removed before any audio or transcript touches disk.
Recognized 2025
ICMI Best Technology Solution. CMP Leading Provider in Quality Monitoring.
What our clients say we do
They do not just fill the seats. They tell us what the calls are actually saying, help us redesign the workflow, and quietly ship the automation that takes rework off our team.
CAHPS. Star Ratings. PDC. Provider NPS. The contract references your metrics.
4,000+ team members. Seven sites. Servant-leadership at every level.
Speech analytics surface the failure points. Findings route to workflow, not just coaching.
A 250-engineer AI lab inside the contract. No third-party margin stacking.
Live programs, anonymized
Distribution. Veterinary. Specialty pharmacy. Each program anchored to its own audience and outcome metric. Each one engineered on the same operating principles: tenured agents, the client's scorecards, process intelligence as a first-class input, and a measurement system that covers every interaction.
Pharmaceutical distribution
Fortune-10 pharmaceutical distributor
Tenured pods sized to the quarter-end curve. Churn signals surfaced inside the week, not the quarter.
Veterinary distribution
Largest veterinary distributor in North America
One operating spine, one coaching cadence. Automation absorbs the repeat reorders. Tenured agents keep the practice relationship.
Specialty pharmacy and pharmacy benefits
National specialty pharmacy and pharmacy benefits
Journey mapping found the friction. Coaching corrected the workflow, not the agent. Adherence followed.
Run. See. Build. Applied to healthcare.
Most healthcare BPOs offer one of these. A few offer two. The value of the full stack lives in the handoff: process findings that flow into workflow redesign, workflow redesign that flows into automation, automation that protects tenured agent capacity for the relationship-critical work.
Member and patient support, enrollment, pharmacy, patient access, provider relations, claims, and distribution order desks. Direct accountability for hiring, training, retention, ramp, and throughput. Servant-leadership management model. Tenured pods, not rotated shared floors.
CAHPS-aligned QA. Adherence-cohort tracking. Provider-NPS attribution. Full-population speech analytics that separate process failure from people failure so coaching and workflow redesign go where they actually move the metric.
A 250-engineer AI lab. Healthcare-tuned speech recognition, custom PHI redaction models, real-time agent assist for prior authorization and appeals, and workflow automation for repetitive order and refill patterns. No third-party margin stacking. The IP we build for your program belongs to your program.
Healthcare-grade delivery footprint
U.S.-heavy by design. Onshore, nearshore, and offshore delivery configured per program, with BAA flow-down across every subprocessor, PHI zoning, and full BCP redundancy across regions.
U.S. headquarters
HIPAA BAA scope, PHI-zoned workspace, clean-desk compliance. Anchor delivery center for healthcare programs.
Pharmaceutical distribution hub
Long-running wholesale and specialty distribution desks. Some of the longest-tenured healthcare agents in the network.
Bilingual member services
English and Spanish member support, AEP surge capacity, and CMS-compliant enrollment operations.
Nearshore
English-first nearshore delivery for member care, claims intake, and escalations in near U.S. time zones.
AI lab and extended operations
ETSLabs engineering, model training, back-office claims, and 24/7 technical support under SOC 2 attested controls and BAA-compliant access.
Continuity is an operating choice
The healthcare BPO category has moved through platform consolidation, offshore margin compression, and private equity roll-ups in rapid succession. Each cycle changed the people running the account. Each change reset continuity, retriggered HIPAA training, and broke the trust bank with members and providers. Etech is privately held, founder-led, and has carried the same compliance record since 2003.
Speak with a healthcare operations lead
Share your program scope, your current QA coverage and agent tenure profile, your CAHPS, Star Rating, adherence, or provider NPS targets, and the regulatory framework you operate inside. A healthcare operations lead, not a sales coordinator, will read it and respond within one business day with a concrete point of view.
