CitiusTech GenAI Payer Agent Assist

"Due to large call volumes, Payer call center agents find it challenging to quickly answer a member query accurately about their benefits. These delayed or inaccurate responses can end up causing an inferior member experience.

Tailored for call center executives, CitiusTech's GenAI Payer Agent Assist can help transform call center operations. This solution empowers call center agents to swiftly access and summarize essential details from varied sources (Plan details, claims details, demographic data and Member Benefits booklet), enabling them to provide more efficient and effective responses to member queries.

Agent Value Proposition:

- Intelligent Information Retrieval: Extracts relevant and precise data quickly from various sources, including member databases containing plan particulars, claims records, demographic information, and Member Benefit booklets.

- Conversational Summaries: Responses to queries are provided in a clear and concise conversational format enabling agents to resolve member queries swiftly and comprehensively.

- Personalized Outreach content: Beyond query resolution, the solution can automate personalized communication thereby further, enhancing the member experience.

- Consistent Communication: Enables agents to ensure every member interaction is consistent, with responses aligned to organizational standards, and regulatory guidelines and minimizing risk of errors.

Member Value Proposition:

- Faster query resolution: Members can quickly get answers and a better understanding of their benefits.

- Reducing Call Transfers: By enabling agents to handle a broader range of member queries, the need to transfer calls to other agents is significantly reduced which helps provide a more pleasant member experience.

Azure Services Used: Azure Form Recognizer, Azure Blob Storage, Azure Cognitive Search, Azure Open