HealthcareMediCare Solutions8 weeks
AI support that resolved 60% of tickets overnight
A healthcare services company was drowning in repetitive support tickets. A knowledge-grounded AI assistant now handles 60% of volume overnight — with human handoff and full audit trails.
- of tickets resolved by AI without human touch
- 60%
- median first response time
- 26h → <1 min
- compliance findings across audits
- 0
The Challenge
- Support volume had doubled year over year while the team stayed at 14 agents — average first response sat at 26 hours.
- Answers touched policy, billing, and clinical schedules; generic chatbots had failed before because they hallucinated.
- Compliance required every AI interaction to be auditable, with sensitive topics escalated to humans.
The Solution
- A RAG pipeline grounded in 1,200+ approved policy documents, so every answer cites its source.
- Strict escalation rules: anything involving PHI, billing disputes, or clinical advice routes to a human with full context.
- WhatsApp-first deployment — the channel their customers already use — plus web and phone integration.
- An evaluation harness with 300 test questions that catches regressions before customers do.
“Our customers get answers at midnight and our agents work on the cases that need a human. It's the best support decision we've made in a decade.”
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