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Health and Wellness Benefit Provider Boosts CSAT 
to Over 94% Leveraging Agent AI and Chatbots

Health and Wellness Benefit Provider Boosts CSAT to Over 94% Leveraging Agent AI and Chatbots

Industry

Healthcare

case studies

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Our client, a health and wellness benefit provider, offers supplemental benefits and reward programs to incentivize better healthcare outcomes for millions of members. Currently, 97% or more of individual plans offer supplemental benefits, including vision, fitness, hearing, and dental benefits. As CMS looks to increase the utilization and appropriateness of these supplemental benefits, Conversational AI solutions are crucial for empowering agents and engaging members, ensuring they take full advantage of the available programs.

The Challenge:

Our client offers an over-the-counter benefits program and serves over 15 million Medicare Advantage members. Committed to fostering healthier lifestyles among its members, the client routinely deploys targeted programs aimed at making healthy products accessible and affordable.

At the start of each Medicare plan year, member inquiries regarding supplemental benefits and rewards pour relentlessly into the client’s contact center. To manage the surge in call volume, the client must swiftly onboard over 800 agents within a three-month timeframe and prepare them for the upcoming peak season. Achieving this demands a careful balance: equipping agents with updated information and enhancing their skills without compromising empathy, accuracy, and compliance.

ResultsCX was entrusted with engaging members to take ownership of their health by utilizing healthy foods, discounts, and allowances on over-the-counter (OTC) self-medications to enhance their well-being. Some of the key objectives included:

  • Meeting Average Handle Time (AHT) targets while maintaining call quality.
  • Closing gaps in the knowledge base hinder agent effectiveness and hamper their ability to achieve high CSAT.
  • Implementing an outbound scripting mechanism and ensuring the ability to pivot quickly.

The Solution:

Using our proprietary knowledgebase, SupportPredict, the client strengthened every step of the member engagement process. Chatbots assist agents in retrieving information and resolving member queries promptly, enhancing efficiency and helping agents avoid penalties for inaccuracies.  Rapid integration of new knowledgebase updates ensures agents have the latest information, improving the agent experience and decreasing Average Handle Time (AHT).

At the same time, our experts foster and maintain a culture of empathy and proficiency among the agents. Enhanced team communication, coupled with incentives and training programs, helps instill a sense of empathy in every interaction. Agents are not just solving problems; they are connecting with members on a deeper level, ensuring their needs are met with understanding and compassion.

As part of our ongoing commitment to excellence, we continue to make various enhancements to the knowledgebase. These include improving the search functionality, enabling convenient access to a repository of frequently accessed solutions, and deploying chatbots to identify the two most common inbound call drivers and script outbound campaigns.

The Results:

As a result of these efforts, our client witnessed remarkable improvements in agent effectiveness, quality, and overall performance – both in inbound and outbound functions. The call center became a hub of efficiency and empathy, where every interaction left a lasting impression on the members. And with each success story, our partnership with the client has grown stronger, paving the way for continued innovation and excellence in customer service.

  • 124-second improvement in Average Handle Time (AHT)
  • 22% improvement in speed to proficiency for new agents
  • 7.4% improvement in quality
  • 94.25% Customer Satisfaction (CSAT) achieved
  • 111.3% show rate of new and existing agents

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