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The primary business of the client is to provide healthcare cost optimization techniques to its customers. They also offer subrogation and overpayment recovery, drafting and evaluation of healthcare plans, and legal expertise based on the customer’s requirement.

Business Need

The company wanted a solution based on generative AI to replace their legacy technology stack solution and upscale their knowledge base. Also, the client needed an automated system which answers queries related their business operations.

Solution

SoPhia provides a chatbot interface using retrieval augment generative to answer their queries related to their business domain. SoPhia also provides an easy interface to maintain the knowledge repository which the chatbot uses to answer the questions.

Additionally, the chatbot can assess compliance with current legal standards. SoPhia maintains historical data about customer interactions and past queries avoiding repetition or duplicate queries.

SoPhia is the backbone for all chat services provided within the different products of the client. For example, it integrates with healthcare contract creation/evaluation product to create new contracts, perform verification checks to identify discrepancies of their medical insurance contracts and assists their customers build robust contracts.

Business Benefits

SoPhia was launched at a conference held by the client. The chatbot received positive reviews from the customer’s partners and clients.

Few of the key benefits include:

  • Quicker response to incidents and inquiries
  • Improved customer engagement
  • 24/7 availability
  • Improved scalability and cost reduction
  • Efficient claims processing
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