Leading US health insurance company selects eGain to modernize member service

eGain announced that a leading US health insurer selected its award-winning eGain AI Knowledge solution.

Health insurance customer service, with its broad range of customer issues and stringent compliance requirements, is very challenging. According to Accenture, healthcare ranks 18th among 20 sectors in their NPS (Net Promoter Score) assessment across industries.

Noting that their member service reps struggle through voluminous, often conflicting documents to resolve customer queries on the phone, the client sought out a knowledge management solution which could guide service agents with ease, speed, and confidence.

eGain emerged a winner in a rigorous selection process that included an extensive pilot, based on functionality, quick value, and domain expertise. The solution will assist agents across customer queries for plans, coverage, benefits, claims, billing, dispute resolution, Medicare, and ACA. Thousands of contact centre agents will use eGain AI Knowledge to resolve member issues and provide advice on health plans. The client will leverage deep context from the company’s CRM and billing systems to personalise guidance.

“The growing information haystack in health insurance can only be tackled with AI-powered knowledge solutions like ours,” said Ashu Roy, eGain CEO. “We are delighted to help our client empower their service agents with conversational guidance and process adherence at scale.”

About eGain

Our omnichannel customer engagement solutions power digital-first experiences for leading brands. Infused with AI, machine learning, knowledge and analytics, our award-winning platform helps clients automate and optimize customer journeys via virtual assistance, messaging, social, mobile, web, and contact centres.

To learn more about eGain, visit www.eGain.com.