success story

Optimized call handling time by 75%

Virtusa partnered with a national healthcare payer to optimize call handling time through domain and technology consulting

In today’s world, customers expect high-quality, consistent customer service from their healthcare plan and expect every agent to be familiar with their needs and the purpose of their call.

Our client, a leading US healthcare payer, dealt with a scattered customer service setup due to various complex systems. This led to inconsistent service levels across departments or channels, causing prolonged wait times and repeated calls as agents struggled to find relevant information, resulting in a poor user experience."

Tackling challenges

Fueled by an anticipated, substantial increase in member and provider calls in the coming years, the company needed to address key challenges to tackle the surge, such as:

  • Siloed customer service applications across various business lines lead to inconsistent customer and agent experiences.
  • Longer average handle time due to multiple systems needed to address different types of call intents. 
  • Insufficient training for specialized advocates results in frequent call transfers.
  • Inadequate governance led to the accumulation of technical debt over time.
  • Inconsistent call logging hampering insights, operational optimization, and workflow intelligence.

Additionally, the future solution should be scalable to handle 60+ million calls annually while incorporating modularized architecture to promote re-usability and rapid expansion to other LOBs. 


Journey from evaluation to recommendation

Virtusa evaluated the client's contact center infrastructure and created a roadmap to enhance capabilities and user onboarding. They conducted a thorough assessment of challenges, and proposed solutions, and collaborated closely with the client's teams to align technical recommendations, offering a roadmap with multiple MVPs.

Solution and the way forward

Virtusa partnered with a Low Code No Code provider to overhaul the client's contact center. They introduced a unified agent desktop, integrating all systems for a seamless user experience in call management and customer service ticket handling.

Virtusa teamed up with a Low Code No Code partner to revamp the client’s contact center with a unified agent desktop that connects to all systems to enable a seamless user experience for managing calls and customer service tickets.

The implementation aimed to boost capabilities in the contact center for members and providers, addressing call intents such as claims inquiries, benefits management, and authorization checks. Our approach was thorough, leaving no aspect unexplored to optimize performance and effectiveness.

This collaboration expanded further to include various technology implementations, such as:

  • Service Cloud lightning to ensure a consistent agent experience for handling various call types, creating cases, and routing them to L2 teams when needed.
  • Open CTI (Computer Telephony Integration) integration with the client’s preferred telephony solution.
  • A single pane of glass Service Cloud with over 100 integrations optimized via MuleSoft.
  • MuleSoft AnyPoint unifies the client’s diverse data sources and applications in a single abstraction layer.
  • Experience Cloud helps connect members with dedicated care advocates for specific use cases, promoting digital engagement and reducing call volume.
  • Utilized value-added services like platform team, quality, gamification tools, and steering committee to promote best practices.
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Boost in contact center performance

Collaborating with Virtusa led to significant improvements in the client's contact center experience, including:

  • 27.5% lower call transfer rate for the provider contact center.
  • Up to 75% reduction in average call handle times in the member contact center.
  • Deployed over 150 technical and business resources.
  • Improved agent experience with an easier-to-use system, leading to better outcomes for members.
  • Decreased agent onboarding and training costs and timelines.
  • Rapid scalability and rollout to additional LOBs using reusable components and APIs.
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