1.7 Million Reasons to Rethink Member Support
A leading BCBS health insurer was fielding 1.7 million calls and 209,000 chats a year. Support teams were stretched. After-hours coverage was limited. Members were waiting. And traditional call center scaling wasn't going to solve any of it.
The math was simple and unsustainable: more volume, same resources, growing frustration on both sides of the phone.
An AI Agent That Works Every Hour You Don't
We deployed an AI-powered virtual agent directly into the member portal. Using natural language processing, it handles the requests that make up the bulk of call volume — eligibility checks, claims status, ID card replacements, prior authorizations — without human intervention.
Members get immediate answers on their schedule, not business hours only. CSRs get their time back for the complex cases that actually require their expertise. And the system scales without adding headcount.
Zero Wait Times. 10% More Capacity. Members Who Can Help Themselves.
The results were immediate and compounding. Wait times dropped to zero for routine requests. Advocate capacity increased 10% year over year. And members gained something that matters more than any metric: the ability to solve their own problems at 11pm on a Sunday without sitting on hold.
That's what AI looks like when it works in practice, not just in a demo.