Increasing Medicare Member Engagement with Conversational AI

A mobile app with a live agent for customer service.

Headquartered in Dallas, Texas, this BPO provides inbound and outbound communication services to businesses across a diverse range of industries including insurance, healthcare, telecom, solar energy, and more. As such, the BPO’s workforce handles a wide range of call types, with each individual agent specializing in a specific use case. 


Scaling Operations Without Compromising CX

As a small but fast-growing BPO, scaling operations was a top priority. However, with that growth came the challenge of managing call spikes and ensuring that customers did not have to wait on hold for extended periods of time. The company’s CEO was also concerned about reducing the cost per call and wanted to find a way to optimize operations without compromising the quality of their services.

The CEO sought to leverage conversational AI technology to automate a specific use case he had in mind—making outbound calls on behalf of Medicare to inform qualifying members about free COVID test kits. If a member was interested, the order would be confirmed, and the information passed along to Medicare for fulfillment.

The caveat for the use case was timing—since the Medicare program was only going to run a few short months, setup and deployment for conversational AI solution needed to quick.


Proactive Outreach with the Uniphore Intelligent Virtual Assistant

After consulting with Uniphore on the use case of automating outreach calls and the short timeframe for deployment, the customer was confident in moving forward with U-Self Serve’s intelligent virtual assistant (IVA) solution. The ROI was clear—in order to support concurrent interactions, the BPO would need to hire 130 agents, whereas U-Self Serve could scale demand for a tenth of the cost.

With the goal of going live in one week’s time, Uniphore’s delivery team worked closely with the customer to integrate to their existing dialer and implement the U-Self Serve solution. Per the customer’s request, a script was recorded using studio talent to provide the virtual assistant with a human voice to replicate the agent experience as closely as possible.

With Uniphore’s self-service solution, the BPO achieves a cost saving of $2 per call


Driving Patient Engagement at Scale

Upon launch, the virtual assistant began reaching out to millions of Medicare members to let them know they qualified for free COVID test kits. In addition to confirming orders, the virtual assistant also answered commonly asked questions that members had about the testing kits. For less commonly asked questions, such as if a patient was interested in receiving test kits but wanted them sent to a different address, the virtual assistant would transfer the call to a live agent and provide context for a seamless handoff.

Early results of the U-Self Serve solution has been promising, with the intelligent virtual assistant engaging more than a half million Medicare members. By automating this high-volume use case, the BPO is able to scale operations, reduce costs, and deliver a frictionless customer experience without additional strain to its workforce.

And with the government program now extended for an additional three months, the virtual assistant will continue reaching out to qualifying members and increasing patient access to COVID testing kits.


Fast-growing BPO providing inbound and outbound communication services for businesses across a diverse range of industries


Automate outbound calls to Medicare patients about COVID test kits


Reduce cost per call and scale operations


U-Self Serve intelligent virtual assistant for voice


At Uniphore, we believe companies that best understand and take action on those 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.

Learn more about Uniphore’s solutions for healthcare