Help beneficiaries enroll while every disclaimer stays on the record
Beneficiaries call for help finding a provider or the right plan, on calls that carry the CMS disclaimer, the Scope of Appointment, and ten years of records. Balto finds the provider on its own, keeps the required language on screen, and writes the enrollment notes.
Health insurance isn't one call
A Medicare enrollment agent, a member-services rep, and a billing specialist don't have the same day. But all of them work compliance-heavy calls under strict CMS and HIPAA rules, for callers who often need help finding the simplest detail.
AEP and disclosures
On a Medicare Advantage or Part D sales call, the agent reads the CMS TPMO disclaimer verbatim before benefits, handles the Scope of Appointment, and keeps the call for ten years. Enrollment periods flood the floor with new, greener staff.
Providers and plans
Older beneficiaries often can't hand over the exact detail (the doctor's name, the spelling, the location) so there's a slow back-and-forth while the agent waits. Plan and formulary questions pile up on top.
HIPAA and the record
PHI has to be protected under HIPAA, disclosures said the right way, and every call recorded and kept. The documentation has to be clean and complete, not reconstructed after the fact.
Everything the agent needs, on the call
The beneficiary's history is on screen at hello. When they name a provider, Balto finds it on its own. The verbatim TPMO disclaimer sits locked on a checklist. The notes write themselves.
It reaches the agents who usually ignore agent assist
A search box only helps the agents who use it, and that's your new hires, not your veterans. The provider lookup is pure push help, so it lifts both at once.
Won't stop to type
They know the plans, so they won't query a box for basics. The provider lookup wins them, because it happens without asking and kills the slow part of the call. The locked TPMO disclaimer and the notes keep them compliant and out of the paperwork.
Buried in CMS rules
Plans, formularies, and the CMS rules are a lot at once. They lean on the lookup, and the locked disclaimer and Scope of Appointment steps keep them compliant before they have it memorized. Big help when AEP floods you with new hires.
Makes the right moves routine
Consistency on the required disclaimer and on the discovery that gets a beneficiary to the right plan. Notes capture the enrollment without slowing the call.
Covered without training
Temporary agents handle sensitive calls sooner because the checklist and the lookups carry the load they haven't learned yet. The thin view keeps it simple.
For managers
Run compliance-heavy, deadline-driven work with a team that balloons at AEP.
- lockLock the verbatim TPMO disclaimer so a reworded version never risks your contract.
- travel_exploreBalto finds the provider on the agent's behalf, so handle time drops on the calls that used to drag.
- sync_altClean enrollment notes land in your system as a structured record.
- verified_userWhen a CMS audit or a complaint comes, you can show the disclaimer happened word for word.
Why it's different
Recording is table stakes. Help during the call is the difference.
- record_voice_overThe verbatim TPMO disclaimer, fired as a locked step, not checked afterward.
- travel_exploreThe provider Balto goes and finds on its own, mid-call.
- edit_noteEnrollment notes that write themselves, no reconstruction later.
- groupsReaches your veterans and your AEP hires, not half the floor.
Ask your call data a question, then ship the fix
Kodi reads every call and answers in plain language, with the calls to back it up. Agentic Insights finds the complaint pattern costing you the most and turns your best agents' approach into guidance for everyone.
Every health insurance call scored against your scorecard
Not a sample your team hand-scores weeks later. 100% of calls read the same day, against the criteria your compliance team uses, with the TPMO disclaimer and disclosure lines flagged the moment they're missed.
GEHA lifted its win rate from a 28% baseline to 50% at peak with consistent, guided agents.
Every call scanned for the required disclaimer the same day, with exceptions routed automatically.
AmTrust reduced its QA analyst headcount from 3 to 0 by scoring every call automatically.
FAQs
Does your current tool read the verbatim TPMO disclaimer as a locked step, and does it go fetch a provider mid-call, or does it only record and summarize after? The recording is required by CMS anyway. The value most tools miss is the help while the call is still live.
You lock the verbatim TPMO disclaimer and the Scope of Appointment steps so they happen on every call, prompted live rather than checked afterward. Every call is scanned the same day for a missed or reworded disclaimer, with exceptions routed. When a CMS audit or a complaint comes, you can show the disclaimer happened word for word.
When a beneficiary says they see Dr. Susan Gray in Fenton, Missouri, Balto finds that provider on its own (the name, specialty, address, and a link) while the agent keeps talking. Nobody has to stop and ask, so it speeds up the slow part of the call for veterans and new hires alike.
In your enrollment or CRM system, as a structured record instead of a scribble. The enrollment details are captured during the call and written back automatically, which is where the time savings come from.
No. The provider lookup and the history reach them without training, and the checklist carries the required disclaimer. Seasonal AEP agents can run the thin view and stay covered on the compliance moments.
See Balto on one of your calls
Bring a real enrollment or member-services call. We'll show you the provider found on its own, the disclaimer on the checklist, and the notes writing themselves.
Book by phone
+1 (405) 864-4645Call and speak directly with our AI agent to schedule your demo, available 24/7, no wait time.
Call now- Give agents the right answer in real time, pulled straight from your own knowledge base.
- Coach faster. Balto spots who needs it, does the prep, and takes you right to the coachable moments.
- See the trends driving your business out of the box, no setup required.
- QA every conversation automatically, so all that’s left is a quick review before it reaches leadership.