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Case study

The challenge

For a large managed health plan client, fragmented contact center systems were causing disjointed, frustrating member experiences. Calls about orders, refills, prescriptions, and bills accounted for a very high call volume—approximately four million each year. These high call volumes resulted in long hold times. Due to the lack of IVR self-service capabilities, agents had to handle all calls personally, which resulted in long handle times and an inability for agents to spend quality time resolving more complex calls. These delays in call response resulted in a high call abandonment rate, which risked member dissatisfaction. Additionally, the disjointed systems provided leadership with a fragmented view of analytics, which hampered its ability to pinpoint and address the sources of delays. The client wanted to consolidate as well as modernize and digitize its contact centers by incorporating conversational AI.

Our approach

The client engaged with Cognizant to rationalize its complex contact center technology landscape, and improve call resolution and member experience metrics. We upgraded the company’s contact center platform to the latest digitally compatible Genesys solution to provide superior agent and member experiences in its contact centers. After reviewing potential conversational AI options, Cognizant recommended based on its strategic alignment, future product roadmap, cost of implementation and usage, time to market and ease of use.

Our team analyzed the client’s existing call and chat conversations, trends in key topics and frequent utterances, and identified top use cases for self-service. Cognizant trained and fine-tuned the grammar for more than 10 use cases across orders, payments, claims, prescriptions, online issues, billing and benefits. We engineered the AI solution deployment in phases, prioritizing business users, call drivers based on impact to call volume, and rollout time. We also engaged linguistic experts to test the system with various tones and pitches real callers would use to validate the member experience.

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Cognizant leverages to enhance call experiences

As a result of our partnership, the client has improved call deflection toward self-service, which allows agents to focus on those calls that required more complex and time-consuming resolutions. adoption has led to significant improvements in call volumes, handle times and authentication time, which has resulted in positive member experiences. Visibility into the entire contact center ecosystem has also given the client a better view into its overall performance, allowing it to identify and address further opportunities for improvement. 


intent recognition rate


authentication rates 


self-service containment