The challenge
For a large managed health plan client, fragmented contact center systems were causing disjointed, frustrating member experiences. Calls about orders, refills, prescriptions, and bills accounted for a very high call volume—approximately four million each year. These high call volumes resulted in long hold times. Due to the lack of IVR self-service capabilities, agents had to handle all calls personally, which resulted in long handle times and an inability for agents to spend quality time resolving more complex calls. These delays in call response resulted in a high call abandonment rate, which risked member dissatisfaction. Additionally, the disjointed systems provided leadership with a fragmented view of analytics, which hampered its ability to pinpoint and address the sources of delays. The client wanted to consolidate as well as modernize and digitize its contact centers by incorporating conversational AI.