Call center ai · Production

HOPE AI voice assistant answers 100% of insurance FAQ calls at Southwest General, saving $4 per call

The problem

Payer contract negotiations triggered a surge of insurance inquiries from patients worried about billing, coverage, and network status. Staff struggled to keep responses current, could not cover after-hours calls without adding shifts, and spent significant time on repetitive questions instead of urgent patient needs.

Workflow diagram · grounded in source
1
Patient calls insurance line
trigger
“Any patient calling the designated insurance line during the payer negotiations could be greeted by HOPE and receive automated help, regardless of which facility they typically visit”
2
HOPE answers with AI voice
ai_action
“as an AI agent, HOPE provides 24/7 response capabilities, extending crucial support beyond traditional call center hours”
3
Escalation to live agent
routing
“The AI Voice project posed a low risk to clinical care and could send calls to staff if needed”
4
Content governance and testing
validation
“The team used a structured testing and content governance process to guide deployment, including leveraging approved content only, running organized test cycles, and following escalation call processes”
5
Knowledge base updates
feedback_loop
“the team had to rapidly update HOPE's knowledge as new information came in. They ensured those time-critical updates were reflected in the voice assistant's responses”
Reported outcome

HOPE handled 40-60% of inbound insurance inquiries during the project, resolved many calls without a live agent, and generated $4 per call savings projected at full scale, while providing 24/7 patient access and freeing staff for more complex issues.

Reported metrics
Per call savings$4 per call
inbound insurance FAQ calls answered100%
Inbound insurance inquiries handled40-60%
Calls resolved without live agentresolved many calls without involving a live agent
Show all 5 reported metrics
per call savings$4 per call
inbound insurance FAQ calls answered100%
inbound insurance inquiries handled40-60%
calls resolved without live agentresolved many calls without involving a live agent
staff availability for complex issuesfreeing staff to resolve more complex issues
Reported stack
HOPE
Source
https://www.notablehealth.com/customer-stories/southwest-general-health-center-hope-ai-voice-assistant
Read source ↗

Frequently asked questions

What did this team achieve with this AI workflow?

HOPE handled 40-60% of inbound insurance inquiries during the project, resolved many calls without a live agent, and generated $4 per call savings projected at full scale, while providing 24/7 patient access and freei…

What tools did this team use?

HOPE.

What results were reported?

Per call savings: $4 per call; inbound insurance FAQ calls answered: 100%; Inbound insurance inquiries handled: 40-60%; Calls resolved without live agent: resolved many calls without involving a live agent (source-reported, not independently verified).

How is this call center ai AI workflow structured?

Patient calls insurance line → HOPE answers with AI voice → Escalation to live agent → Content governance and testing → Knowledge base updates.

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