Live policy answers
The agent has the FINEOS record open during the call. Coverage, billing and claim questions get a real answer.
FINEOS
Orvera + FINEOS Integration
Orvera AI connects to FINEOS, so its agents can serve claimants straight from the live record. The agent checks absence and disability claim status for the caller. If a call needs a claims specialist, it goes to your team with the whole story attached.
FINEOS
Orvera AIHow it fits
Does Orvera integrate with FINEOS?
Yes. Orvera AI works with FINEOS and with the CRM and contact center tools you already run beside it. Employees on leave call to check where their absence or disability claim stands. The agent checks the status in FINEOS and explains the next step. The agent sticks to the steps your team approved, and we build and deploy the connection.
Built in
- role-based access controls
- encrypted data transmission
- SOC 2 Type II certified
What you get
What does the Orvera and FINEOS integration do?
Questions in your order
Every intake follows the script and checks your claims and service teams signed off on.
Context on every turn
Policy details and earlier contacts stay in view, so the caller only explains the situation once.
Records written back
After each call, the summary, outcome and next step land in your systems.
End to end
How is the Orvera and FINEOS integration set up?
- Step 01
Interaction initiated
A claimant calls, chats or emails, and the agent picks it up right away.
- Step 02
Workflow execution
First it checks who they are. Then it follows the steps your team approved for that request.
- Step 03
Context applied
It reads the policy and claim details from FINEOS and answers from what's there.
- Step 04
System updated
After the conversation, the summary, outcome and any requested change are recorded.
- Step 05
Action triggered
If a call needs a claims specialist, it goes to the queue you chose, summary and all.
In practice
Built for policy and claims service
Policy and claim questions
The agent checks absence and disability claim status for the caller.
Handoff and escalation
A claimant who needs a person goes to the team you picked for that case, and the summary goes with them.
After-hours and overflow coverage
Claim questions come in at all hours, and the agent takes every call right away.
Post-conversation follow-up
Once the conversation ends, the agent can kick off whatever follow-up your team set for that outcome.
Capabilities
What your team gets with Orvera and FINEOS
Voice, chat and email
The same workflows run on every channel your customers use.
Agent Assist on live calls
When a person takes the call, Orvera AI Agent Assist puts the FINEOS details and the next step on their screen.
Conversation summaries
Each conversation gets a short summary your team can read in a few seconds.
AI Quality Management
Every conversation gets scored against your quality checklist, whether the AI or a person handled it.
Reporting on every interaction
Contact reasons, outcomes and handoffs sit in one report, so you can see what's behind your volume.
FINEOS
What outcomes does the FINEOS integration deliver?
- Policy questions answered from the live record
- Less manual lookup work for your team
- Handoffs carry the whole conversation
- Coverage after hours and at peak times
- A clear record of every outcome
Related
Related Integrations
How do you get started with Orvera and FINEOS?
We start with your FINEOS setup and the claimant calls you get most. Then we design the workflows, build them and deploy them. Full deployment lands in 3 to 6 weeks, and we keep running the agents after they go live.