Case in point A trans man has grown accustomed to annual pap smear claim denials based on the gender “M” in his medical record. Data analytics and refined algorithms that flag and reconcile the discrepancy to override the gender-based rule, enable a person born as a woman who identifies as a man, to receive the care, respect, and coverage he deserves. A healthcare advocate assures the member he will no longer encounter such claim denials. When the two discover they are both fans of the same sports team, the member feels comfortable enough to disclose additional personal information that helps the advocate provide even better, more personalized support.
Solutions • AI-based bots for training, coaching • Role-playing exercises enable new hires to practice their skills in simulated interactions before moving to live customer calls • Feedback loop so high-performing practices can be replicated across the organization • NPS surveys, ongoing monitoring of CSAT and DSAT
See how it’s done
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