Virtusa Secures SIIA CODiE Awards for Best Artificial Intelligence Solution in Healthcare

success story

Call handling time optimized by 75% for a National healthcare payer

In today’s day and age, customers expect high-quality, consistent customer service from their healthcare plan and for every agent to know the customers and the purpose of the call. Our client, one of the USA’s largest healthcare payers, faced a fragmented customer service environment and many complex systems. Customers experienced different levels of service depending on the department or channel they engaged with and often experienced long wait times as agents located the relevant information.

The solution – is a unified agent desktop powered by Salesforce that connects with all the systems and data sources. The same solution is also capable of a single-user experience for handling calls and creating customer service tickets. With the power of MuleSoft, over 100 different APIs provided real-time healthcare data to agents, accelerating call handle time by up to 75%. At the same time, self-service Experience Cloud portals connected members with advocates digitally, driving down call volume.

The Challenge

Current infrastructure impacts user experience and the payer’s ability to scale

The healthcare payer’s contact center infrastructure created a slow and inefficient user experience. Fueled by an anticipated, substantial increase in member calls in the coming years, the company needed to address key challenges to tackle the surge, such as:

  • Multiple siloed customer service applications amongst the different lines of business, resulting in inconsistent CX and AX.
  • Higher than desired average handle time due to the number of systems involved in resolving different types of call intents. 
  • Specialized training of advocates to handle call types led to high volumes of call transfers. 
  • Inconsistent and inadequate call logging reduced the ability to gather insights, drive long-term business operations optimization, and build intelligence into workflows. 
  • The future solution should be scalable to handle 60+ m calls per year and incorporate modularized architecture to promote re-usability and rapid expansion to other (Line of businesses) LOBs. 

The company partnered with Virtusa to transform its contact center operations to address these challenges.

The Solution

Unifying data and applications in a single layer with MuleSoft AnyPoint and data lake integration

We utilized our partnerships with leading technology companies to reinvent the healthcare payer’s contact center infrastructure.

The following are the technologies included:

  • Salesforce Service Cloud lightning with a consistent agent experience to handle a variety of calls types and create cases to log the calls and route them to L2 teams if necessary 
  • Open (computer telephony integration) CTI for integration with the client’s preferred telephony solution 
  • MuleSoft AnyPoint to unite the company’s disparate data sources and applications in a single abstraction layer 
  • Experience Cloud to connect members with dedicated care advocates for specific use cases – enabling digital engagement and driving down call volume
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The Benefit

Reduced call handling times improve user and customer experience.

Collaborating with Virtusa and its technology partners drives substantial improvements in the company’s contact center experience.

The improvements include:

  • A 27.5% lower call transfer rate for the provider contact center
  • Up to a 75% reduction in average call-handle times in the member contact center
  • An easier-to-use system that elevated the agent experience and translated into better outcomes for members who called the contact center
  • Reduced agent onboarding and training costs and timelines
  • Rapid scalability and roll out to additional LOBs with re-usable components and APIs
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