Transform agent performance and call monitoring in healthcare

Our client, a healthcare payor’s inadequate call monitoring system, concealed agent performance quality. Hence, it became difficult to detect trends and identify areas for improvement. A more insightful analysis system was essential to improve service quality and efficiency.

Only 2% of calls were audited, meaning agents missed valuable insights and opportunities to improve member retention, ensure compliance, and identify areas for agent training. This time-consuming, manual process couldn’t harness complete insights from customer interactions.

Additionally, the agents had to listen to calls and take notes simultaneously, often missing important details about customer interactions. Without a more comprehensive way to monitor calls, the healthcare payor lacked visibility into overall agent quality and could not identify trends or patterns in performance.

The healthcare payor recognized the need to transcend their manual process to analyze agent performance and member interactions effectively for the larger picture. The need emerged for an advanced tech solution to ensure the payors delivered the highest-quality care and support.

Our team engineered the Customer Interaction Insights (CII) solution to address the problem. Harnessing Azure OpenAI generative AI LLMs, CII automatically analyzes voice call transcripts to extract information on call reasons, customer intents, sentiments, attrition indicators, and other agent performance indicators.

Our advanced solutions approach involved persona-based dashboards. The healthcare payor now had a powerful tool to discern agent performance trends and gain valuable insights.

The adoption of CII led to an 80% reduction in manual call audits, freeing up significant resources for the healthcare payor’s staff. With call quality being monitored more comprehensively, the payor was able to identify areas where agents needed improvement and provide them with targeted coaching. This resulted in a 30% improvement in agent compliance with company policies and procedures.

The improvements in agent performance also led to a 20% increase in Net Promoter Score (NPS), a key customer satisfaction metric. By automating the process of taking notes, CII also helped agents save 20% of their time, allowing them to focus on providing better service to customers. Overall, this large healthcare payor significantly improved efficiency, agent performance, and customer satisfaction by automating agent quality monitoring with GenAI.