Customer Interaction Insights automates agent call monitoring for a large healthcare payor 
Call center insurance company
2 min. read

Customer Interaction Insights automates agent call monitoring for a large healthcare payor 

Challenges

The healthcare payor struggled with a time-consuming and manual process for monitoring agent calls. Only 2% of calls were audited, meaning they missed valuable insights and opportunities to improve member retention, ensure compliance, and identify areas for agent training.  

Additionally, the agents had to listen to calls and take notes simultaneously, so important details about customer interactions were often missed. 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. 

Solution

Recognizing the limitations of their manual monitoring process, the healthcare payor needed a solution that could provide a more comprehensive picture of agent performance and member interactions. This was crucial for ensuring the payor was delivering the highest-quality care and support.  

In response, Fractal deployed its Customer Interaction Insights (CII) solution that leverages Azure OpenAI generative AI LLMs to automatically analyze conversations at scale. CII can analyze voice call transcripts to extract information on call reasons, customer intents, sentiments, attrition indicators, and other agent performance indicators.  

Fractal also built persona-based dashboards to help the healthcare payor identify agent performance trends and other valuable insights. 

Results

The implementation 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 metric of customer satisfaction. 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, by automating agent quality monitoring with generative AI, this large healthcare payor was able to significantly improve efficiency, agent performance, and customer satisfaction.