What do the rules ask of a health insurer’s phone line?
For health insurers, the ANS rule on serving members is Normative Resolution No. 623/2024 (Resolução Normativa nº 623/2024). The official ANS FAQ says arts. 8 and 9 of that resolution govern 24-hour phone service for urgent and emergency care. Decree No. 11,034/2022 (Decreto nº 11.034/2022) sets the general rules for SAC, the customer-service channel Brazilian law regulates.
The FAQ reference is the document published by ANS itself, in the version of September 17, 2025: the RN 623 FAQ on the ANS website. Which insurers are subject to each rule, and for which requests, is what legal counsel needs to confirm in the text of the resolution.
The decree, which each regulator applies to its own industry, sets the general minimums for phone service, in the official text on the Planalto website:
| Rule | Provision | What it says |
|---|---|---|
| ANS, RN 623/2024 | Arts. 8 and 9, according to the ANS FAQ | 24-hour phone service for urgent and emergency care |
| Decree No. 11,034/2022 | Art. 3 | Free access to SAC, at no cost to the consumer |
| Decree No. 11,034/2022 | Art. 4 | 24-hour access through at least one channel; phone mandatory |
| Decree No. 11,034/2022 | Art. 5 | At least 8 hours a day of live-agent service; complaints and cancellation in the first menu; maximum wait time set by the regulator |
The guide SAC Decree and RGC: how to prove the 0800 was up explains each article of the decree.
What does it mean when the insurer’s 0800 is down?
A health insurer’s 0800 being down means members cannot reach their plan by phone on the very channel ANS associates with urgent and emergency care. Requests for care, coverage questions and complaints go unanswered, and the problem reaches the insurer some other way.
The failure is not always a dead number. The number may connect and play the wrong message: the carrier recording saying the number does not exist, the after-hours IVR stuck during the day, an old greeting after a platform change. The PBX dashboard stays green. Only a call coming in from the outside shows what the member hears.
How does Monitor check the 0800 and the IVR?
Monitor places a real test call to each of the insurer’s service numbers at the agreed pace, 24 hours a day, including overnight and on weekends. Each call checks that the number went through and that the IVR answered with the reference greeting 2N5 recorded during setup.
A failed call is retried three times, every 2 minutes; four consecutive failures open an incident with the SIP code and Q.850 cause of each call, and the escalation ladder is notified by email and SMS until someone takes ownership. A single blip wakes nobody up. See 0800 and IVR monitoring and alerts and escalation.
How does the SLA report show 24-hour availability?
The SLA report shows the availability of each number for the month and for the last 12 months, calculated over every test call, day and night. It lists each incident with its start, end and duration, and the time until someone took ownership, and arrives by email every month for the people the insurer chose.
A period when 2N5 could not test because of a problem on 2N5’s side is left out of the calculation and shown separately, and planned maintenance logged in advance in a maintenance window is also left out. See SLA reports and the SLA calculator.
What does the test not cover?
The test does not cover the wait time to reach an agent, live-agent hours or the content of the conversation with the member. It shows that the number went through from the 2N5 platform and that the right IVR answered, at each tested time, and nothing more.
Monitor dials numbers: it does not connect to the insurer’s contact-center platform, does not read queues and does not access member data. The Security and LGPD page covers what is kept and for how long.
Frequently asked questions
Which ANS rule covers phone service?
ANS Normative Resolution No. 623/2024 (Resolução Normativa nº 623/2024) covers how health insurers serve their members. The official ANS FAQ on RN 623, in the version of September 17, 2025, says arts. 8 and 9 govern 24-hour phone service for urgent and emergency care. Which insurers and which requests each article covers should be confirmed in the text of the rule.
Does Monitor call the insurer's 0800 overnight?
Yes. Each number has its own schedule, at intervals or at fixed times, including at night and on weekends. At the standard pace, each number gets a call every 15 minutes, and a failed call is retried every 2 minutes before any alert.
Does the test call tie up an agent at the contact center?
Not when the number is answered by the IVR or a recording: the call listens for the expected greeting and hangs up. If a person can answer the number, they hear a message saying it is an automated test, and the call ends.
Do you store member data?
No. Monitor only places its own test calls and never keeps a person's voice. A call's audio is kept only when the recording or IVR you named is what answers, encrypted and for 90 days, to prove that the line works.