One of America's top 10 health plans selects HiLabs' agentic voice intelligence, Built on clean, timely provider data, to redefine payer-provider outreach. Aug 04, 2026, 08:00 ET Built on HiLabs' industry-leading provider data foundation, the platform transforms every payer-provider conversation into trusted operational intelligence - moving beyond the limitations of generic AI voice platforms. WASHINGTON, Aug. 4, 2026 /PRNewswire/ - HiLabs, Inc., the AI company built to solve healthcare's hardest operational and data challenges, today announced the enterprise deployment of HiLabs MCheck(R) Intelligent Outreach by one of America's leading health plans. The healthcare-native agentic voice intelligence platform will support multiple high-priority provider data workflows, marking another milestone in HiLabs' mission to eliminate payer-provider friction through trusted provider intelligence. The announcement comes as health plans accelerate investments in agentic AI. Earlier this year, the nation's largest health insurer announced a $3 billion AI investment, with AI agents increasingly supporting provider-facing operations. The question is no longer whether AI will transform payer operations, but whether it is purpose-built for healthcare. AI Voice Isn't the Innovation. Trusted Provider Intelligence Is. Every provider conversation has the potential to improve provider directories, accelerate credentialing, strengthen regulatory compliance, increase survey completion, and reduce administrative burden. Yet for decades, provider outreach has remained one of the most labor-intensive and fragmented functions inside a health plan, relying on manual calls, disconnected workflows, and outdated provider data. The challenge has never been making phone calls. It has been turning every provider interaction into trusted operational intelligence. Generic AI voice platforms can automate some conversations with mixed results because they are not purpose-built for healthcare. Provider outreach requires trusted provider data, healthcare-specific workflows, regulatory context, and payer business rules to make interactions meaningful. Without this foundation, AI spends valuable time discovering provider information and context instead of validating it. This limits the quality of the interaction and the value of the outcome while increasing the risk of provider abrasion. HiLabs MCheck(R) Intelligent Outreach Platform (IOP) is built on the same provider data foundation that powers HiLabs' industry-leading Provider Directory Accuracy platform. Built on the principles of data reliability, relevance, and recency, that foundation has been independently validated through peer-reviewed research published in the Journal of the American Medical Association (JAMA) and referenced in MedPAC's Report to Congress. Rather than starting every conversation from scratch, HiLabs begins with trusted provider intelligence. Built on a continuously validated provider data foundation, the platform reaches the right providers with accurate contact information from the outset and focuses conversations on targeted confirmations instead of lengthy discovery. Every interaction produces clean, structured, auditable data - not another unstructured call log. The result is higher-yield outreach, a better provider experience, and trusted operational intelligence that continuously strengthens the underlying provider data foundation. "Every major technology shift creates an opportunity to rethink how an industry operates. Agentic AI represents that opportunity for healthcare. But AI is only as intelligent as the data it can trust. For more than a decade, HiLabs has built one of healthcare's most trusted foundations of clean, timely, and continuously validated provider intelligence. That's what enables our AI agents to deliver real-world outcomes - not just conversations." - Amit Garg, Co-founder & Chief Executive Officer, HiLabs Under the new engagement, MCheck(R) IOP will initially support quality survey operations before expanding to provider directory validation and targeted provider surveys. Each workflow is powered by healthcare-specific logic, payer-grade integrations, and structured data capture, ensuring every conversation continuously improves the provider intelligence that powers downstream operations. Custom Engineered for the Scale and Complexity of Healthcare Operations The HiLabs MCheck(R) IOP directly addresses persistent pain points that cost health plans tens of millions of dollars annually - inaccurate provider directories that trigger CMS and state regulatory penalties, provider verification processes bottlenecked by manual call volume, and survey completion rates too low to generate statistically valid insights. By automating these workflows intelligently, HiLabs enables health plan operations teams to reallocate staff capacity toward higher-complexity, judgment-intensive work while simultaneously improving data quality and regulatory defensibility. Key capabilities of the Agentic Outreach Platform include: * Healthcare-native conversational intelligence - trained on tens of thousands of real healthcare provider call recordings and transcripts provide interactions designed around the real-world vocabulary, workflows, and compliance requirements of health plan operations, not repurposed consumer IVR logic * Agentic call orchestration - navigates multi-level IVRs including DTMF menus and voice-activated prompts, recovers from transfer loops, works through fallback numbers automatically, consolidates multiple verifications into single interactions where appropriate, maintains full audit trails on every attempt * Script quality scoring - evaluates campaign design before launch, with completion time estimates, question quality scores, and projected response rates * Structured data capture and downstream integration - every interaction produces clean, structured outputs that feed directly into provider data management systems, credentialing workflows, and reporting pipelines * Compliance-grade auditability - full interaction logging and audit trails designed to support NCQA, CMS, and EQRO review standards * Measurable cost and quality outcomes - reduction in manual outreach labor costs and improvement in directory accuracy rates From Provider Outreach to Continuous Provider Intelligence MCheck(R) IOP costs one-fifth of traditional manual outreach - saving health plans millions annually at enterprise scale. Volume scales with infrastructure, not headcount: adding 50,000 calls/month requires no new hires, no training cycles, no ramp-up time. New campaigns launch in two days versus four to six weeks for manual operations. Benchmarked directly against both manual outreach and open-source voice automation at leading health plans, MCheck(R) IOP delivers superior accuracy, response rates, and structured output quality - advantages that compound as call volume and campaign complexity grow. This engagement advances HiLabs' vision of transforming provider outreach from a manual administrative function into a continuous source of trusted operational intelligence. Every provider interaction becomes an opportunity to improve the data foundation that powers provider directories, credentialing, compliance, and network operations. For decades, provider outreach has been measured by calls completed. The next generation of healthcare operations will be measured by intelligence captured. About HiLabs HiLabs, Inc. is a healthcare AI company focused on solving the most complex challenges in health plan data, outreach, and operations. Its MCheck(R) platform suite is deployed by leading national and regional health plans to reduce friction across payer-provider workflows and lower the cost of operation at scale. Built with deep healthcare domain expertise, HiLabs combines applied AI with operational intelligence to deliver measurable, production-grade outcomes across high-impact workflows. The result is infrastructure that enables health plans to operate with precision, maintain audit-ready data, and meet rising regulatory demands with confidence. SOURCE HiLabs

Harvard researchers partner with HiLabs to study ghost networks and real-world access to care across Medicare Advantage. Jun 30, 2026, 08:00 ET HiLabs, Inc. and Dr. Thomas Tsai announce a multi-year research collaboration to measure true access to care and expose ghost networks affecting 35 million Medicare Advantage enrollees. WASHINGTON, June 30, 2026 /CNW/ - For 35 million Americans enrolled in Medicare Advantage, finding a doctor should not be the hardest part of getting care. Yet for millions of beneficiaries, provider directories that look complete on paper mask a different reality: providers who are unreachable, no longer participating, or not accepting new patients. These are ghost networks, and they represent one of the most consequential and least examined failures in American healthcare today. HiLabs, a leading healthcare data intelligence company whose work directly supports health plans in meeting CMS network adequacy standards and federal directory accuracy requirements, announced today a multi-year research collaboration with Dr. Thomas Tsai, Associate Professor in the Department of Health Policy and Management at the Harvard T.H. Chan School of Public Health and Associate Professor of Surgery at Harvard Medical School, to study provider network adequacy and ghost networks in Medicare Advantage. Eliminating ghost networks and delivering true network adequacy has been at the core of HiLabs' mission since its founding. Five of the nation's ten largest health plans and dozens of regional carriers rely on HiLabs' MCheck(R) Provider suite to move beyond paper compliance and know, in real time, what their network can actually deliver for members. Processing hundreds of millions of provider records and continuously validating provider availability across thousands of data sources has given HiLabs an unmatched operational view into where ghost networks are most severe and what it takes to close the gap. Most recently, a leading national behavioral health plan selected HiLabs to achieve true network adequacy across its network, demonstrating the operational impact of this approach at scale. This research collaboration extends that mission into the scientific domain, contributing real-world provider data and AI-powered ghost network detection to help independent researchers measure the problem at a national scale for the first time. The collaboration will examine how ghost networks affect access to care for Medicare Advantage enrollees, evaluate how practitioners measure and experience network adequacy in practice, and assess what the gap between listed and accessible providers means for patient outcomes. Medicare Advantage network adequacy is under intensifying federal scrutiny. CMS audits are increasingly focused on the gap between what provider directories list and what members can actually access. For older adults and people with long-term disabilities enrolled in Medicare Advantage, a ghost provider is not an inconvenience, it is a barrier to care. At the moment it is most needed. "As more Medicare beneficiaries elect to enroll in Medicare Advantage, federal policymakers should evaluate whether beneficiaries can access a diverse array of high-quality physicians, hospitals, and other healthcare facilities necessary to achieve optimal health outcomes," said Dr. Thomas Tsai. "This collaboration will allow the Healthcare Quality and Outcomes Lab to conduct cutting-edge research to ensure Medicare beneficiaries are able to access the care they need under private Medicare Advantage health plans." The findings will give health plan leaders, CMS, URAC, and state insurance regulators the clearest independent picture yet of where the gap between listed and accessible providers is most acute, and what it costs the millions of beneficiaries whose access to care depends on the accuracy of those networks. "Network adequacy is foundational for healthcare access. Patients must be able to connect with their doctors, and that starts with dependable networks, not just directories that appear complete on paper, but networks that are continuously validated to reflect who is genuinely available to members," said Amit Garg, CEO and co-founder of HiLabs. "We are proud to support Dr. Tsai's critical research with the data and AI capabilities needed to understand how provider networks function in the real world." The research collaboration is expected to extend over multiple years. Findings will be disseminated through appropriate research and academic channels as the work advances. For health plan leaders whose network strategy rests on the assumption that listed is the same as available, this research will be difficult to ignore. About HiLabs, Inc. HiLabs, Inc. is a healthcare AI company focused on solving the most complex challenges in health plan data, outreach, and operations. Its MCheck(R) platform suite is deployed by leading national and regional health plans to improve provider data accuracy, streamline compliance workflows, and fundamentally reduce the cost of operating at scale. Built with deep healthcare domain expertise, HiLabs combines applied AI with operational intelligence to deliver measurable, production-grade outcomes across high-impact workflows. The result is infrastructure that enables health plans to operate with precision, maintain audit-ready data, and meet rising regulatory demands with confidence. For more information, visit www.hilabs.com or contact us. About Dr. Thomas Tsai Thomas Tsai, MD, MPH, is an Associate Professor in the Department of Health Policy and Management at the Harvard T.H. Chan School of Public Health and an Associate Professor of Surgery at Harvard Medical School. He serves as the Medical Director for Health Policy Research for the American College of Surgeons and is a practicing surgeon at Mass General Brigham. His research focuses on healthcare delivery, access to care, and the impact of policy and organizational structures on patient outcomes. SOURCE HiLabs

HiLabs has deployed its MCheck NetworkIQ platform with a national behavioral health organisation serving millions of members, as ghost networks face intensifying federal scrutiny. The announcement comes as federal investigators found 55% of behavioral health providers listed in Medicare Advantage directories are inactive, and state regulators impose multimillion-dollar penalties on plans with unreliable networks. A Senate Finance Committee study found 80% of provider listings across 12 major Medicare Advantage plans were inaccurate or unavailable. Research suggests 40% to 80% of behavioural health providers listed in directories may be unreachable or not accepting new patients. NetworkIQ uses AI to continuously validate which providers are genuinely active and accepting patients, replacing manual, point-in-time network management. The platform tracks CMS, state and NCQA network adequacy standards whilst incorporating telehealth providers into adequacy calculations.