Boosting Healthcare Plan Enrollment and Operational Efficiency with Agent Guidance

A computer screen displaying a dashboard providing guidance for Healthcare BPO operations.

This award-winning and tech-enabled healthcare services company specializes in consumer communication and member retention for major healthcare payers and providers. During open enrollment, their contact center employs over 3,000 agents to assist with healthcare-related queries, ranging from verifying member eligibility to helping members enroll in healthcare plans such as Medicare and Medicaid.


Modernize the Technology Stack

As part of a strategic plan to modernize their technology stack, the healthcare services company wanted to replace its existing agent guidance tool that was cumbersome to use and required IT support to manage. 

First and foremost, the company needed a solution that would seamlessly integrate with their new CCaaS provider—which had yet to be finalized. Secondly, the solution needed to comply with the standards and processes of the healthcare providers they represented. Lastly, the solution had to be easy to use and manage without any coding. 


Simplify Agent Guidance and Workflow Processes with U-Assist

The company decided to partner with Uniphore and implement its real-time agent guidance offering, U-Assist, based on the solution’s unique ability to work with any CCaaS provider and technology stack. With U-Assist, the company could simplify workflows and improve agent productivity without worrying about any constraints of their new CCaaS provider—effectively future-proofing their investment and allowing for operational scalability.

The rollout of U-Assist significantly reduced scripting time—what used to take months to complete, now only took a few short weeks. The solution was also rolled out to the agent workforce, who now had turn-by-turn guidance for various call types such as:

Member Authentication

Eligibility Verification

Enrollment for Medicare and other healthcare plans

Agent transfer to appropriate payer or provider  


Higher Enrollment Rates and Improved Operational Efficiency

The value of U-Assist was proven early on during the busy annual enrollment period (AEP). Agents were able to leverage U-Assist’s guided workflows to help members navigate complex healthcare plans and assist with the enrollment process.

The number of successful enrollments with the U-Assist solution far exceeded expectations. Not only did U-Assist’s guided workflows reduce agent time to proficiency, but it also accelerated agent performance. For the company, initial results “spoke to what the agents are able to do with Uniphore and gives us a big opportunity for the future.”

With the implementation of U-Assist, the company also improved operational efficiency. “Before, to do a change was 3+ hours after-hours, and now scripting, campaigns, call routing, etc. is so much easier and a lot better in the new environment. [U-Assist] has allowed us to be more nimble, do change, and be flexible.”


  • Tech-enabled healthcare services company specializes in connecting the healthcare industry to consumers, and providing patients with better access to healthcare


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“Uniphore is our NUMBER ONE partner. It’s there for the agent; it never goes down.”


Guided workflows for healthcare plan enrollment and healthcare service-related queries


Replace outdated agent guidance and scripting tool with an easy-to-use solution that integrated with any CCaaS provider and technology stack


U-Assist real-time agent guidance solution with next best actions


At Uniphore, we believe companies that best understand and take action on enterprise conversations will win. We have built the most comprehensive and powerful conversational automation platform that combines conversational AI, knowledge AI, and emotion AI with a business user-friendly-UX in a single integrated platform to transform and democratize customer experiences across industries.

U-Assist Resources

What is real-time agent coaching and why do call centers need it?

Learn more about Uniphore’s solutions for healthcare