Healthcare Customer Service Outsourcing That Puts Patients First
Deliver secure, compassionate support across every patient and member touchpoint. Our HIPAA-compliant call center team helps providers, payers, and wellness organizations improve access, strengthen trust, and scale with confidence. From appointment access and benefits coordination to telehealth support and medical record inquiries, we handle sensitive interactions with the accuracy, compliance, and empathy your teams depend on.
Healthcare Support Powered by People and Technology
Patient care depends on clear communication, accurate information, and trust at every point of interaction. Five Star supports healthcare organizations with an operating model that connects patient data, service workflows, and trained care support teams to provide reliable assistance across voice and digital channels.
AI-assisted tools and automated workflows are used where appropriate to guide interactions, streamline routine requests, and improve consistency—within secure, compliance-aligned environments. These capabilities help reduce effort and support timely responses, while experienced specialists handle conversations that require sensitivity, accuracy, and sound judgment. More complex issues, including billing questions, care coordination, eligibility concerns, and policy clarification, remain firmly human-led to ensure patients receive the right answers at the right time.
By combining scalable technology with healthcare-trained teams, organizations maintain consistency during periods of high demand without compromising quality or oversight. The result is clearer communication, fewer handoffs, reduced escalation pressure, and patient experiences that feel informed, respectful, and supported.
Customer Care for Healthcare Providers
Improve patient access, reduce administrative burden, and deliver consistent, compassionate support across your clinical and operational workflows.
Appointment Scheduling
Give patients fast, frictionless access to care. We manage inbound and outbound scheduling, rescheduling, cancellations, and waitlist workflows, ensuring accurate intake, reduced no-shows, and a smoother experience for both patients and clinic staff.
Patient Billing & Financial Support
Help patients understand their statements, payment options, and account balances with clear, empathetic support. We reduce confusion and improve the overall patient financial experience by assisting with billing questions, payment processing, financial responsibility explanations, and navigating online portals,
Medical Records Coordination
Help patients access their health information securely and without delay. We support record requests, release-of-information inquiries, portal navigation, and status updates—all handled under strict HIPAA standards and in alignment with HIM requirements to protect privacy and ensure accurate documentation.
Health Plan Review
Help patients understand their coverage with clear, accurate, and empathetic support. We explain benefits, copays, deductibles, network requirements, and out-of-pocket expectations, while also assisting with plan enrollment and renewal questions. This reduces confusion, supports timely access to care, and strengthens financial transparency across the patient experience.
Telehealth & App Tech Support
Ensure patients can confidently access virtual care. We assist with portal and app navigation, login issues, video visit setup, device troubleshooting, and telehealth appointment scheduling, removing barriers so patients can connect with providers quickly and without frustration.
Policy & Procedure Support
Give patients clear guidance when they’re unsure about practice policies or next steps. We answer questions about clinic procedures, preparation instructions, visit requirements, and general expectations—delivering consistent, accurate information that reduces confusion and supports smoother care experiences.
Patient Inquiries & General Support
Provide patients with fast, reliable answers to everyday questions. We help with appointment details, directions, hours, provider information, portal assistance, and other non-clinical inquiries, delivering accurate, HIPAA-compliant support that keeps your front desk and clinical teams focused on care.
Patient Enrollment & Engagement
Support patients in joining and staying connected to your programs. We assist with enrollment questions, eligibility guidance, reminders, and general outreach—helping improve participation, reduce drop-off, and strengthen long-term patient engagement.
Support Services for Health Plans
Deliver accurate, compliant member support that strengthens understanding, improves service quality, and ensures every interaction aligns with your plan’s operational and regulatory standards.
Member Support & Coverage Guidance
Provide members with clear, compliant explanations of their plan benefits. We support inquiries related to coverage rules, eligibility, deductibles, network guidelines, and policy details, delivering accurate information aligned with your plan’s documentation and regulatory standards.
Claims Status Support
Give members clarity on where their claims stand. We help with claim status inquiries, EOB guidance, required documentation updates, and general process questions—providing accurate, timely information aligned with your plan’s policies and regulatory requirements.
Enrollment & Eligibility Support
Assist members with understanding their eligibility, enrollment steps, renewal timelines, and required documentation. We help members navigate coverage changes with confidence by providing clear, compliant guidance aligned with your plan’s standards.
Provider Directory Assistance
Help members find in-network providers quickly and accurately. We support directory navigation, provider searches, location and availability questions, and plan-specific network guidance—ensuring members connect with the right care options under your coverage rules.
Appeals & Grievances Support
Assist members with navigating the appeals and grievances process. We provide clear guidance on required steps, documentation, timelines, and status updates, handling every interaction accurately and in alignment with your plan’s regulatory standards.
General Member Support
Provide members with fast, accurate assistance for everyday plan questions. We help with policy details, ID card requests, coverage guidelines, portal troubleshooting, and other non-clinical inquiries, delivering reliable, compliant support that enhances the member experience.
Support for Your Internal Teams
Strengthen healthcare operations with support designed for complex, regulated environments. Healthcare organizations use Five Star to manage patient and member interactions across scheduling, billing, eligibility, care coordination, and policy-driven inquiries—while adhering to established compliance, privacy, and documentation requirements.
Operating as an extension of your team, trained specialists follow organization-approved workflows, data handling standards, and escalation protocols to support HIPAA-compliant processes and other regulatory obligations. Interactions are documented consistently, sensitive information is handled securely, and issues requiring clinical or administrative review are routed appropriately. Flexible staffing helps organizations remain responsive during enrollment periods, seasonal volume shifts, and unexpected events without disrupting clinical, compliance, or operational priorities.
The result is cleaner escalation paths, more reliable documentation, reduced compliance risk, and internal teams that stay focused on delivering care, managing cases, and supporting patient outcomes.
I cannot stress enough how much we appreciate the communication and speed at which we were able to address [the Coronavirus Pandemic]. A true testament to the partnership and relationship we have between our groups.
— Head of Patient Support
Proven Results
See how leading healthcare providers and payers partner with Five Star Solutions to elevate service quality, reinforce compliance, and scale support across every touchpoint.
A healthcare technology company needed to eliminate a 20,000-record backlog and scale support quickly. Five Star Solutions deployed a 60-agent team with standardized workflows to deliver consistent, compliant results at speed.
What We Delivered
20,000-record backlog cleared using a cross-trained workflow
60 agents hired and trained through a scalable enablement model
Multichannel coverage across phone, email, and digital channels
Faster service delivery with accurate documentation
A health benefits organization needed to reduce call volume and improve member resolution rates during peak periods. Five Star Solutions implemented an automated, multi-tier support model that strengthened accuracy and increased efficiency.
What We Delivered
20% of calls automated through targeted workflows
30% program cost reduction with optimized routing
12% decrease in AHT through faster resolution steps
+10% first call resolution supported by data-driven accuracy
2-day faster onboarding using a streamlined training model
Whether you need to improve patient access, strengthen member services, or support internal teams across your healthcare organization, Five Star Solutions delivers secure, compliant, and compassionate CX at scale. Connect with our healthcare team to explore a tailored support model designed around your goals.
