success story

Spearheading the Pega Voice AI implementation for a leading healthcare payer

It all started with one of the leading health payers facing significant hurdles in delivering efficient and personalized customer service. Long wait times, manual information intake processes, and a lack of customer engagement had a bad impact on customer satisfaction, resulting in increased costs, and reduced productivity. Recognizing the need for a more effective solution, they sought to improve operations and enhance customer service. Well, the health payer came to the right source of assistance; Virtusa presented a solution that is the first-ever Pega Voice AI implementation in the healthcare industry.

The Challenge

The traditional contact center model proved inadequate in meeting the escalating demand for support, prompting the search for a transformative approach. This health payer’s goal was to break free from inefficiency and unlock new levels of productivity, engagement, and cost-effectiveness.

Driven by a commitment to excellence, they embraced cutting-edge technologies and innovative strategies to reshape the customer service landscape. Through meticulous research and strategic partnerships, they discovered a game-changing solution.

Spearheading the Pega voice AI implementation in healthcare payer industry
The Solution

Virtusa thrives on pushing boundaries and revolutionizing customer service. In collaboration with our esteemed client, Virtusa harnessed the power of the latest advancements in the Pega Platform and Voice AI technology to spearhead a groundbreaking initiative – Pega Voice AI solution in the healthcare payer industry.

Our mission was to deliver an intuitive and personalized customer service experience that would transform the industry landscape for both customers and agents alike. Leveraging the capabilities of the Pega Platform and Voice AI, Virtusa embarked on an extraordinary journey towards creating a customer-centric ecosystem that would redefine the standards of excellence for this healthcare payer.

One of the key achievements was the development of a co-pilot capability for contact center agents, revolutionizing their experience and enhancing their efficiency. By integrating intelligent automation and Voice AI technology, we empowered agents with the tools they needed to deliver exceptional service, all while elevating the experience of constituents.

During the pilot rollout, we focused on implementing high-value, high-impact use cases that delivered tangible benefits. These included intent tasks, HIPAA compliance, automated form filling, knowledge management articles, and next-best-action tasks. By leveraging the power of Voice AI, we optimized these processes, enabling seamless interactions, improved compliance, and enhanced decision-making.

The results were remarkable. The implementation of Pega Voice AI in the Healthcare Payer industry paved the way for a new era of customer service excellence. Customers experienced intuitive and personalized interactions, while agents were equipped with cutting-edge tools to enhance their performance and productivity.

We are not done yet, there is more to our solution.

The following are the upcoming Voice AI features:

Sentiment analysis

Live transcription

Enhanced reporting

Wrap up summary

The Benefit

Pega Voice AI is powered by real-time speech-to-text transcription and natural language processing (NLP) models, and here is how it revolutionized customer service and drove remarkable benefits for this healthcare payer

Reduced wait times and handling times, resulting in faster response and improved customer satisfaction.

Call intent prediction for faster processing and guided next-best-actions for agents.


Automated form completion to improve data accuracy and speed up Average Handling Time (AHT).

Compliance monitoring for script adherence and HIPAA compliance.

Knowledge management support by mapping customer intents to related content, reducing AHT and training needs.

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Explore the limitless potential of Voice AI in enhancing customer service, empowering agents, and optimizing operational efficiency.

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