Empowering Healthcare Contact Centers
When a large health plan needed a better way to ensure call-center agents followed strict compliance procedures, they looked for a modern, scalable approach. Partnering with Pellera AI, they implemented Contact Center IQ (CCIQ) as part of a pilot initiative currently in production. This cloud-native AI platform is already transforming operations by automating compliance validation, unlocking deep operational intelligence, and demonstrating measurable efficiency gains, including a 25% reduction in average call handle time within the pilot environment. As the organization prepares for a broader enterprise rollout later this year, these early results are expected to scale further.
The Challenge
In the heavily regulated healthcare industry, accuracy and compliance are non-negotiable. A major health plan faced a significant challenge: they needed to know if their call-center agents consistently adhered to required compliance procedures. Manual reviews could only cover a fraction of the total call volume, leaving potential compliance gaps.
Beyond risk management, the organization saw a broader opportunity. They wanted to empower their teams by leveraging AI to enhance service quality, improve visibility, and gather actionable operational intelligence across the entire contact center. They needed a secure, innovative solution that could handle massive scale without compromising patient privacy or regulatory standards.
The Approach
To drive meaningful momentum, Pellera AI introduced Contact Center IQ (CCIQ). Built as a cloud-native AI platform and securely deployed on NVIDIA AI Enterprise on Azure, CCIQ delivers compliance intelligence and operational transformation at scale.
We designed this platform specifically to align with stringent healthcare regulatory/compliance and security controls. By moving away from manual post-call documentation, we empowered agents to focus entirely on the member experience, while the AI handled the heavy lifting in the background.
The Solution
The CCIQ platform bridges strategy and technology by utilizing advanced AI capabilities to support both agents and leadership. Key features include:
01
LLM-Driven Call Analysis
Evaluates conversations directly from call recordings to understand context, sentiment, and accuracy.
02
Agent Performance Scoring and Coaching
Provides targeted analysis to help supervisors mentor their teams effectively.
03
Process Improvement & Automation Insights
Highlights recurring friction points and recommends streamlined workflows.
04
RAG-Based “Ask Away” Feature
Allows leaders to query the entire database of call logs for instant, accurate insights.
05
Customer Journey Analysis
Maps turn-by-turn interactions to better understand the member experience.
06
Secure Healthcare Deployment
Maintains strict alignment with essential regulatory and data security controls.
The Results
By putting people first and equipping them with seamless technology, the health plan is already realizing meaningful outcomes through this production pilot deployment:
100% automated compliance validation (pilot scope)
The platform validates compliance requirements across all calls within the pilot environment, eliminating the blind spots of manual sampling.
25% reduction in average handle time
By eliminating the need for manual post-call documentation within the pilot group, agents are processing calls significantly faster, freeing them up to help more members.
Enhanced experiences
Both customers and agents are benefiting from smoother, more supportive interactions backed by AI-driven insights.
Strategic automation
The platform has already identified three high-value opportunities for further process improvement and automation.
As the organization moves toward full production rollout later this year, these benefits are expected to expand across the broader contact center environment.
Conclusion
By deploying CCIQ through a phased, production pilot approach, this large health plan is turning a standard compliance challenge into a catalyst for operational excellence. As the solution scales across the enterprise, Pellera continues to partner closely with the organization to unlock its full potential—creating seamless workflows, strengthening compliance, and driving sustained business impact. Learn more about our Healthcare IT Solutions and Services.
