FOR HEALTH PLAN CONTACT CENTER LEADERS
Your contact center platform tells you what's happening. Your conversations tell you why.
The Contact Center Ops Guide: From What to Why
Find out where your conversation data could be cutting handle time, reducing repeat calls, and getting your team ahead of open enrollment.
Here's what you'll walk away with:
A 5-minute self-assessment to gauge your operational visibility across handle time, first-call resolution, IVR effectiveness, agent coaching, and open enrollment readiness
A clear picture of where your unstructured data has the most to offer
What other health plans have found when they uncovered the why in their conversations
Trusted by leading health plans
500M+
healthcare conversations analyzed
100%
of interactions reviewed, not a QA sample
45 days
Average time to go live
The Visibility Gap
The signals are already there. You're just not hearing them.
2%-5%
Seriously?
This is the average percentage of member calls reviewed through QA sampling. The other 95% go unheard — and they're carrying the answers to your most expensive operational questions.
The process gap your dashboard can't see.
Your AHT keeps creeping up even after you've optimized routing. QA sampling won't find the reason why.
The resolution gap no one can explain.
Members call back about the same issue. Your FCR metric doesn't tell you whether it's a routing problem, a knowledge gap, or a process no agent could fix.
The signal hiding in plain sight.
Every repeat call, every long hold, every agent who quietly burns out is a signal. Most ops teams are too buried in volume to hear it.
These aren't edge cases
They're happening in every shift, every queue, every day. In conversations no one's reviewing. Now you can hear all of them.
See it in action
Meet the Authenticx Platform
Navigate through the prompts to explore the Authenticx conversation intelligence platform.
Your Contact Center Platform vs. Authenticx
Your contact center platform was built to manage operations. Authenticx was built to understand conversations.
One tells you what happened on the call, but the other tells you why it happened and what to do about it.
Authenticx
- Analyzes 100% of member conversations
- Scores every interaction against custom, healthcare-specific rubrics with 97% AI accuracy
- Surfaces the process gaps and friction points driving your numbers
- Reveals why members keep calling back, before it shows up in a complaint or a poor Star rating.
- Surfaces what happened, why it happened, and where to focus next
Your Contact Center Platform
- Manages the queue and routes the call
- Scores the rep against a fixed rubric
- Produces a QA report on a sample of calls
- Tells you what happened, but not the underlying reason why
What Changes When You Can Hear It All
See the signal. Know the cause. Fix the process.
See the root cause, not just the symptom.
Take control of agent performance and member experience by analyzing 100% of conversations. Quickly spot the process gaps and behavioral patterns driving repeat volume, unnecessary transfers, and long handle times.
Coach the moments that matter.
Score 100% of interactions against custom, healthcare-specific rubrics, not a sample. Spot the coaching opportunities and performance trends that actually move quality scores, and give supervisors the specific moments to reinforce.
Get ahead of the next volume spike.
Surface the confusion patterns driving call volume before they compound. Use the time between enrollment periods to prepare for the next one.
Don't Just Take Our Word For It
What other health plans found in their own conversations
18%
reduction in average call handle time — by fixing the process gaps causing long, repetitive calls
300
agent hours recovered every month at a Top 5 Medicare health plan by improving first-call resolution
$800K
in monthly savings after identifying the root cause of repeat calls about the same pharmacy issues
Let's find out where the friction is.
Most health plans don't know exactly where handle time, repeat calls, and agent burnout are coming from until they show up in performance. This is a conversation about finding out where that's happening for you and what it would take to fix it.
Understand your specific challenges. A focused look at where friction is showing up in your contact center and what's driving it.
Get an honest read on fit. We'll tell you directly whether and how Authenticx can help. No pressure, no pitch.
Frequently asked questions
Conversation intelligence uses AI to analyze member conversations across voice, chat, and digital channels to uncover patterns, friction points, and risks buried in unstructured data. For health insurance organizations, it turns everyday interactions into actionable insights that improve experience, enhance quality, and ensure compliance.
Conversation intelligence reveals where members get confused, frustrated, or stuck, so healthcare payers can fix issues at the root cause. By acting on real member feedback, organizations reduce repeat calls, improve member satisfaction, and deliver clearer, more supportive experiences.
Purpose-built, healthcare-trained AI listens at scale, identifying intent, nuance, and safety signals that generic tools miss. It connects millions of interactions into clear patterns that guide smarter decisions and confident action.
Chatbots respond to individual interactions. Conversation intelligence analyzes all interactions across every channel and touchpoint to uncover systemic issues, risks, and opportunities, providing enterprise-level clarity, not momentary responses.
In health plan call centers, conversation intelligence helps scale quality assurance, identify coaching opportunities, and improve first-call resolution. It also surfaces systemic issues—like benefit confusion or process breakdowns—that drive unnecessary volume and lead to member churn.
Healthcare-trained conversation intelligence platforms are built with compliance in mind, using privacy safeguards, redaction, and monitoring to meet HIPAA and CMS requirements. They continuously analyze interactions to detect compliance risks, safety concerns, and documentation gaps across 100% of conversations.
Yes. Conversation intelligence platforms can be tuned to each organization’s lines of business, regulations, workflows, and priorities, whether for Medicare Advantage, Medicaid, or commercial plans. Our AI becomes more precise as it learns your data, processes, and performance goals.
Traditional analytics summarize what’s already known. Conversation intelligence uncovers hidden patterns, emotions, and friction points buried in everyday interactions, turning raw, unfiltered conversations into actionable context.