Excellent clinical care is half the battle in generating healthcare revenue. When practices struggle to connect with their community, it results in missed appointments, delayed payments, and patient attrition, which impact your bottom line. Conversely, active and strategic engagement with patients can boost your practice’s revenue cycle performance. You don’t...
Insurance claims automation is the use of AI-powered self-service to let a policyholder file a claim, check its status, or manage a policy without calling in and waiting on hold. It handles the routine parts of the claims and policy lifecycle end to end, voice and visual together, and hands...
A micro-app in customer service is a small, single-purpose web interface that opens instantly, usually from a link sent during a call or text, and lets a customer complete one task: pay a bill, verify an identity, reschedule an appointment. No download, no account, no menu to navigate. It closes...
Quality management member engagement is the outreach layer that turns a health plan’s HEDIS gap list into completed member actions: screening reminders, medication adherence nudges, annual wellness visit scheduling, and CAHPS-driving touchpoints tied to Star Ratings. The plan already knows which members have an open gap. What decides whether that...
An AI agent in customer service is software that reasons through a request, takes action across live backend systems, and resolves the issue instead of just responding to it. A chatbot, by contrast, matches what a customer types or says to a scripted branch in a decision tree. One completes...
Multichannel means a business runs several channels (call, email, chat, text, portal), each on its own system: nothing carries over. Cross-channel connects some of them, often partway through integration, so a cart or case number sometimes follows the customer while full context usually doesn’t. Omnichannel goes further: every channel reads...
Care management member engagement is the outreach layer that sits on top of a health plan’s existing care management platform. The platform tracks who needs outreach. It doesn’t place the call, retry when nobody answers, or escalate to a live care manager without losing context along the way. That gap,...
Customers have become comfortable managing myriad aspects of their lives through digital experiences. Yet many customer service interactions still begin with a phone call and a maze of menu options. For organizations trying to balance rising customer expectations with operational efficiency, that creates a growing challenge: How do you make...
Omnichannel member engagement is the practice of reaching health plan members across voice, text, email, and web, using the channel and timing most likely to get a response from that specific member. A portal alone can’t do this: it waits for the member to log in. Real omnichannel engagement reaches...
AI member outreach for health plans automates the outbound campaigns that used to run through call center staff, mail vendors, and manual dialing lists: appointment reminders, care gap alerts, open enrollment updates, satisfaction surveys. Health plans using it typically cut cost-to-serve by around 50%, because the AI absorbs volume that...
AI call deflection is the practice of routing incoming calls away from live agents and into automated self-service, so customers get resolved without ever waiting in a queue. Done well, it cuts agent workload, shortens hold times, and lowers cost-to-serve, all while improving the outcome for the person calling in....
A new HIMSS Global Market Insights study just confirmed what many of us in the industry already feel: healthcare AI is advancing – but unevenly, and for most organizations, too slowly. The study surveyed 345 healthcare executives and IT leaders across North America, EMEA, and Asia Pacific. The headline finding...
Across the contact center industry, AI investment has never been higher. Productivity tools have been rolled out, internal copilots have been deployed, and employees at many organizations are using AI to draft communications, summarize interactions, and move faster through their workday. Meanwhile, in those same organizations, customers are still navigating...
Although healthcare organizations are investing heavily in digital transformation, success depends on putting that technology to work to improve patient outcomes. Navigating healthcare software implementation challenges requires strategic alignment across your organization. A strategic approach will help you enhance your existing infrastructure and ensure that your tools work smarter. To...
Government Services Were Built for a Different Era For decades, the government service model has operated the same way: a citizen encounters a problem, picks up the phone, waits on hold, and hopes to reach someone who can help. It’s a reactive model, designed around the limitations of its time,...
