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AmeriHealth is Improving Health Outcomes with Agent Assist

What is the Role of a Contact Center in Improving Healthcare Outcomes?

Make Contact Centers Assistance Centers with Personalization, Automation and Process Guidance

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"Uniphore’s product development and go-to-market strategy is focused on automating customer service operations. It is a pioneer in delivering conversational AI capabilities and has a differentiated value proposition for organizations looking to automate and optimize processes across the customer service value chain"

Amardeep Modi, Practice Director

The Everest group logo on a green background provides Agent Guidance.
Amerihealth logo on a green background showcasing an agent assist theme.

About the Client

AmeriHealth Caritas is a national leader in health care solutions for people who are at a low-income level and/or are chronically ill. AmeriHealth is a provider of health insurance to nearly 260,000 employers and individuals. The company’s contracted hospital and physician network includes thousands of physicians at 76 hospitals throughout its service area.

With a focus on their members’ illnesses and experiences, AmeriHealth sought to simplify contact center operations to provide the most optimal service and experience for their members and employees.

Our Approach

Uniphore is helping AmeriHealth simplify contact center operations with real-time agent assistance, task automation all in a unified agent desktop to boost efficiencies and health outcomes. We integrated 10+ core systems into a single unified application and replaced a legacy case management application. The now integrated case management drives improved process compliance and SLA management across the workforce.  

Member 360 view, interaction history, alerts, care gaps, and next best action are all benefits of the Uniphore solution. Real-time agent assist guides customer service representatives through the entire interaction and now dispositioning and after call work are automated saving agents a significant amount of time. 

Results

  • Holistic Care: Agents make Members aware of care gaps, recommend next best actions driving better health outcomes 
  • Average handle time (AHT) had been reduced by 60 seconds  
  • 20% reduction in training time due to the simplification of the agents workspace and automation of processes 
  • Member experience and satisfaction improved due to the new personalized and prompt service experience 

What's Next

The AmeriHealth team is exploring ways to enrich the agent assistance with additional capabilities that can be seamlessly layered on top of their current implementation. They will remain committed to ensuring they are providing the best possible member experience by utilizing technology that simplifies the job. 

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