Leading Healthcare Company Solves Agent Turnover and Reduces Costs by 65% with AI Self-Service

Success by the Numbers

Engagement Rate
Authentication Rate
Customer Effort Decrease
Monthly Savings

Challenges

  • Could not achieve growth without hiring, training, and retaining live agents
  • Expensive agent costs and time-consuming hiring processes
  • Regulated by HIPAA, requiring a complex patient authentication process

Solution

  • Designed a comprehensive, HIPAA compliant process for automating patient authentication
  • Mimicked agent best practices using advanced artificial intelligence and natural language processing
  • Introduced self-service for patient processes never before thought possible

Results

  • 96% of callers engage and 70% fully authenticate using self-service – rivaling agents
  • Accurately and consistently authenticates callers in less time than agents, decreasing patient effort by 60%
  • Significantly reduces agent minutes, resulting in savings of 65% over live agents

J&B Medical Supply provides medical and surgical products to patients, caregivers, health systems, clinics, and first responders.

J&B partnered with SmartAction initially to handle outbound patient reorders, but the solutions have evolved into a full self-service suite including authentication. By deploying call center automation, J&B has been able to achieve growth, reduce reliance on the difficult process of hiring and retaining live agents, and focus on their core business. As an added benefit, J&B has maintained HIPAA compliance – a key initiative for any Healthcare company.

 

Like any Healthcare company that handles personal information, J&B is bound by HIPAA regulations and therefore has a complex three-factor authentication process for all callers. Since many of the patients that J&B serves are unable to make calls for medical reasons, the typical call could be from a caretaker, nurse, or other family member. This creates challenges when callers do not have the correct information, or do not have the information readily available. This was causing long authentication times, and generally took agents more than three minutes to complete.

Once authenticated, callers were often checking on orders, reordering supplies, or checking on coverage paperwork. These are complex processes required for DME suppliers, specifically those that rely on payors to earn revenue, and agents were the only option for providing customer service. J&B found it difficult and expensive to hire, train, and retain agents – even more so in the particular location that J&B operates.

In cooperation with J&B’s Customer Service Team, SmartAction refined and perfected an approach that was comprehensive and HIPAA compliant, incorporating industry best practices that J&B’s agents had been using. The authentication self-service solution triangulates three pieces of patient data out of a possible six to eight, and uses these data elements to positively identify the caller. Since some of the data points are not always top-of-mind (i.e. Patient ID), the system asks for one of two data elements at the same time to increase the odds that the data being requested is something the caller knows. When a caller does not have some piece of information, the AI-powered engine can move on to ask for a different element.

Voice self-service conversation flow for patient authentication using AI
Diagram 1
AI Bot Converses with Customer

Please tell me the patient’s phone number or Patient ID.

I don’t have it.

AI Bot Converses with Customer

Ok. Let’s try something else. Please tell me the patient’s zip code.

Diagram 2

With self-service that was capable of automating complex but repetitive tasks, J&B could limit their reliance on agents and stimulate growth to reach their lofty expansion goals. Better yet, the distributor could offer 24-hour self-service for those other common tasks that patients were calling about, like order status, reorders, and authorizations.

In just a few short weeks after going live, customers were engaging with the self-service on 96% of calls, and almost ¾ of those callers were fully authenticated without being transferred. J&B was amazed to discover that self-service authentication took less than half the time it took agents, reducing handle times by over two full minutes. By pulling approximately 50,000 agent minutes out of the call center, J&B experienced cost savings of around 65% over their live agents.

“SmartAction has been a long-term partner and has allowed us to automate many of our simple to medium complexity calls, freeing up resources to focus on more value-added activities.  SmartAction has been a true collaborator as we continue to evolve our business.” –Dr. Stephen Shaya, CEO

Given the elderly demographic and the perceived reluctance this population would have in talking to a machine, the successful deployment proved to J&B Medical Supply that AI-powered customer self-service could make an impact on every aspect of the patient experience as it evolves with the future.

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