Elevance Health transforms customer engagement with Pega Voice AI
See how Elevance is boosting agent satisfaction and compliance.
reduction in manual steps
data accuracy for auto-filled forms
improvement in script adherence
The Business Issue
With a mission to elevate whole health, Elevance Health is a Fortune 20 company and one of the largest healthcare groups in the United States. Serving 115 million consumers and members across multiple states, the complexity of their platform – encompassing customer service, provider lifecycle management, and various other functions – was immense.
Elevance Health implemented Pega Customer Service™ to modernize their platform, reduce technical debt, and enhance the customer experience. This journey involved multiple upgrades and modernization efforts, including the creation of a Pega Center of Excellence (COE) to ensure consistent governance across 40 applications.
With this vast array of applications to manage, each with its own unique interface and requirements, agents found themselves bogged down by administrative tasks. They needed to manually search through extensive knowledge repositories for relevant information, strictly adhere to compliance scripts without real-time guidance, and fill out intricate forms – all while engaging with customers. This not only extended the average call handling time but led to increased potential for error and reduced overall efficiency.
The Solution
To address this, Elevance Health implemented Pega Voice AI™ – an intelligent, AI-based voice recognition system that uses machine learning and natural language processing (NLP) to deliver real-time actionable insights to agents during active calls.
The solution addressed several key pain points:
- Agent experience: While listening to agents’ active calls, Pega Voice AI uses speech-to-text and NLP to auto-fill forms and provide real-time, intent-based action suggestions – so agents can focus more on their conversations rather than navigating complex systems.
- Knowledge management: Based on the conversation, it automatically populates relevant knowledge articles, meaning agents no longer have to search through repositories looking for the information they need to fulfill a customer’s request.
- Compliance and script adherence: Voice AI also ensures agents adhere to established scripts, enhancing compliance and improving data quality.
- Post-call transcripts: It generates detailed call transcripts for audit and feedback, in turn enhancing training and operational oversight.
The Results
The deployment of Pega Voice AI at Elevance Health led to significant improvements in operational efficiency and agent satisfaction:
- 10% reduction in manual steps thanks to automated form filling and suggesting relevant knowledge articles
- Decreased average call handle time as agents are freed from manual administrative tasks
- 80% data accuracy for auto-filled forms
- 90% improvement in script adherence
- Higher agent satisfaction, with agents using Voice AI as a co-pilot that makes their work more efficient
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“As the member speaks, we are able to present the agent with what the likely intent is… or the service request that will be called on based on the conversation that's happening between the member and the agent.”