Every Member.
Every Interaction.
Health plans can’t improve what they can’t see. Scala gives member services leaders a complete view across conversations, workflows, systems, human agents, and AI agents, so teams can understand why members keep calling, where risk is building, and what to fix next.
Built for Member Services
Members call when they need help making the right next move in their healthcare journey: understanding benefits, finding an in-network doctor, fixing a claim, navigating prior authorization, or getting the right prescription filled.
Scala connects those conversations across the systems, workflows, and teams behind them, so health plans can better understand what members need, where members are getting stuck, and what teams should do to make the experience easier.
Root cause clarity
Connect conversations with claims, eligibility, and CRM data to understand why members keep calling back.
Every language covered
Evaluate 100% of member interactions across channels and languages with a single QA framework.
From Insight to Action
Insight only matters if it leads to action. Scala helps health plans deploy conversational AI agents across the channels members already use to resolve benefits and claims questions, provider scheduling and more.
Behind the scenes, internal AI agents reduce the manual work that slows teams down, from note taking and call summaries to wrap-up tasks and next steps. Every agent runs inside guardrails your compliance team defines, so automation behaves the way your business expects.
100%
of member interactions seen, scored, and explained across human and AI agents.
20-30%
of repeat and avoidable contact identified by root cause, not buried in dashboards and sampled reviews.
One unified intelligence layer
connecting conversations, workflows, systems, and teams, so health plans can see, understand, and act.
Compliance by design
PHI and PII demand more than a security page. Scala operates under SOC 2 Type 2 and HIPAA compliance standards, with strict data boundaries and controlled, policy-driven integrations into your systems of record. Every interaction is captured with full context and reasoning, so your compliance team gets a complete audit trail, not a blackbox.
Results in Weeks
Scala helps health plans move quickly from visibility to action. QA coverage expands from a small sample to 100% of member interactions. Repeat contact drivers are identified by root cause. And the issues that drive grievances, CAHPS scores, and Star ratings surface before they compound.
Because Scala is AI-native and embeds in the systems you already use, ROI lands in weeks, not months. Nothing to rip out. Nothing to replace.
From Contact Drivers to Better Operating Decisions
After Scala is deployed, member services leaders stop guessing where to focus.
They can see which issues are driving volume, which ones carry compliance or experience risk, and which fixes will have the greatest impact. Coaching becomes more targeted. Automation becomes more precise. Process improvement starts with evidence instead of anecdotes.
The result is a clearer operating rhythm: see what is happening, understand why it matters, and act where the work will change outcomes.
Supercharge your teams and move operations forward.
Fewer surprises. Confident decisions. Real progress on experience and cost.
Book a demo and we'll show you how Scala turns complexity into clarity for teams like yours.