Health Insurer cuts costs and improves CX with unified digital engagement

Health insurer cuts costs and improves CX with unified digital engagement

Rapid migration to conversational AI and live chat delivers 80K monthly interactions and 30% self-service success

5 min Lesen

The Challenge

Fragmented systems driving costs and complexity

A leading U.S. health insurer faced mounting cost pressures and operational inefficiencies caused by a fragmented digital engagement ecosystem. Legacy virtual assistant (VA) and live chat solutions were spread across multiple vendors, creating inconsistent member experiences and escalating service expenses.

The urgency grew as:

A full migration to Nuance Mix and NDEP was required to reduce vendor costs and modernize operations
An aggressive end-of-year deadline loomed, risking continued licensing and integration fees
All lines of business needed a unified experience, front-ending Nuance Digital Engagement Platform (NDEP) Live Chat with Mix VA
Digital engagement had to expand beyond authenticated users to reach prospects and unauthenticated members
Salesforce CRM integration was critical for automated case creation and compliance reporting
The mobile app required asynchronous live chat via Nuance SDK for modern member support

The organization recognized that without a unified, scalable, cloud-based contact center, costs would rise, satisfaction would decline and inefficiencies would persist.

The Objective

Build a future-ready digital engagement model

The client aimed to create a seamless, omni-channel experience that:

Enabled self-service for enrollment and critical tasks via virtual assistant
Ensured smooth human handoff when automation fell short
Automated CRM case creation to eliminate manual errors and improve compliance
Delivered consistent experiences across web, mobile, authenticated and unauthenticated journeys

This wasn’t just about modernization; it was about building a scalable foundation for evolving business and regulatory needs.

The Solution

Rapid migration and unified ecosystem

To meet aggressive timelines and deliver high-quality outcomes, HCLTech partnered with Microsoft and the client’s internal teams using an agile, high-speed delivery model.

A transformation driven by deep collaboration

HCLTech led with a strategic approach that ensured enterprise-wide alignment:

Daily solution modeling, design, development and testing sessions ensured continuous feedback and rapid iteration
Cross-functional collaboration across all major lines of business ensured consistency in experience, compliance alignment and operational readiness
Daily program-level status updates kept leadership informed and enabled fast decision-making
Rolling deployments throughout the year allowed features to go live incrementally, reducing risk and accelerating adoption
Program increment (PI) planning ensured delivery commitments were met and dependencies were properly sequenced, an essential component in large-scale CCaaS transformations

Unified digital contact center ecosystem

HCLTech integrated and migrated the client’s systems to a fully modernized engagement stack:

Nuance Mix Virtual Assistant (replacing IBM Watson)
Nuance NDEP Live Chat (replacing Salesforce Chat)
Salesforce CRM for automated, bi-directional case management
Nuance Mobile SDK for asynchronous live chat within the customer mobile app
Custom Nuance portal analytics for monitoring performance, compliance reporting and ongoing optimization

The result was a cohesive, cloud-based, omnichannel engagement ecosystem that elevated member experience while dramatically improving operational efficiency.

The Impact

Results that redefined digital engagement

The transformation delivered significant improvements in scale, accuracy and cost efficiency:

80,000+ monthly IVA engagements
25,000+ monthly live chat escalations
70% intent recognition accuracy, aligned with industry benchmarks
30% successful self-service completion rate

These outcomes drove:

Major reduction in call center burden
Consistent digital experiences across all member types
Lower operational costs through automation and vendor consolidation
Improved compliance readiness via automated CRM cases
Expanded accessibility for unauthenticated users

By pairing strong governance with agile execution, HCLTech created a unified, scalable digital engagement ecosystem and delivered it within an aggressive deadline to achieve a measurable impact.

This transformation is more than a system migration; it’s a model for how payers can enhance the member experience, reduce costs and prepare for the rapidly evolving digital health landscape.