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Case Study

AI-enabled healthcare support in the Philippines

Since its launch in June, Philcare's chatbot has received over 472,880 messages and helped its members access convenient and accessible healthcare services from 1,600+ hospitals and 48,000 physicians leveraging artificial intelligence (AI) to automate processes such as appointment booking, exam results, and LOA requests.

Client
Philcare

400,000+

members

48,000+

affiliated doctors

1,600+

accredited hospitals

472,880+

messages exchanged

"PhilCare leverages technology to deliver exceptional service to our clients. We believe that strategic partnerships like the one we have with Proto will help us achieve our goals. In just the first few months of using Proto's platform, PhilCare immediately felt an improvement in delivering our services. Thank you to the competent team from Proto!"
Alex Aquino
CTO, PhilCare
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About Proto

‍Proto is the leader for inclusive chatbots and multilingual contact centre automation in emerging markets. Proto’s AI Customer Experience (AICX) platform is powered by proprietary natural language processing (NLP) for under-resourced and mixed languages. The Proto team has successfully developed novel deep-learning techniques and regulatory partnerships to maximize consumer experience, protection, and lifetime value across 20+ emerging markets.

About Philcare

PhilCare is one of the Philippines’s pioneering Health Maintenance Organizations (HMOs), established in 1982. The company is built on a vision to allow Filipinos to enjoy a better quality of life by providing access to world-class health services. Today, PhilCare continues to focus on the customers by delivering innovative and technology-enabled customer experience and improving the customer's access to healthcare services.

Problem

PhilCare relied on customer support via hotline and email. But the growing number of incoming member requests — sometimes thousands per month — was difficult for human agents to handle. Most of the inquiries were simple questions like doctor affiliations and hospital accreditations. However, with only a limited number of agents (10-15) handling the inquiries, this resulted in long wait times and low customer satisfaction, posing a risk to their membership renewal rates.

Solution

In order to address this challenge, PhilCare was looking to automate their contact centre with a solution that could handle large volumes of customer queries with speed and accuracy and would be available 24/7. Given Philcare's diverse customer base, the chatbot would also need to be able to handle inquiries in English, Cebuano, Tagalog, and mixed languages, such as Taglish (mix of English and Tagalog).

Philcare evaluated a few solutions and vendors and, after a one-month trial with Proto, the multilingual chatbot surpassed PhilCare's expectations - reducing members query resolution to 2 seconds and human agents reliance to 52%.

Their hatbot (Phil) was deployed on PhilCare's website and Facebook Messenger, allowing their 400,000+ members all over the Philippines to conveniently access the information they need without having to wait on the phone or for an email response.

Phil is integrated into Philcare's existing internal systems to answer frequently received requests such as:

  • Checking accredited hospitals and clinics
  • Checking affiliated physicians
  • Finding out about plans inclusions
  • Claiming reimbursements
  • Generating LOAs for online or face-to-face consultations

In the coming months the chatbot is being expanded and trained based on Proto Analytics to find out what other other inquiries can be automated and answered by Phil, thus ensuring continuous improvement.

PhilCare CTO Charles Alexis Aquino said: “PhilCare leverages technology to deliver exceptional service to our clients. We believe that strategic partnerships like the one we have with Proto will help us achieve our goals. In just the first few months of using Proto's platform, PhilCare, immediately felt an improvement in delivering our services. Thank you to the competent team from Proto!”

Results

The automated AI-enabled healthcare access solution delivered the following results since its deployment in June 2022.

57,348

chats handled

5,710

inquires on plans and benefits

3,681

inquires on accredited clinics

2,384

inquires on clinics location

2,345

inquires on accredited doctors

472,880+

messages exchanged

1.95s

response time

Approach

Banks

The INTUMWA complaints chatbot is deployed across the websites of Rwanda’s banks for maximum exposure to consumers in need of protection. These banks can choose to upgrade the chatbot with additional capabilities for general customer support, payments, and account management.

nbr example insurance chatbot

Insurance

The INTUMWA complaints chatbot is deployed across the websites of Rwanda’s insurance providers for maximum exposure to consumers in need of protection. These insurance providers can choose to upgrade the chatbot with additional capabilities for general customer support, claims, and coverage applications.

Conclusion

"PhilCare leverages technology to deliver exceptional service to our clients. We believe that strategic partnerships like the one we have with Proto will help us achieve our goals. In just the first few months of using Proto's platform, PhilCare immediately felt an improvement in delivering our services. Thank you to the competent team from Proto!"
Alex Aquino
CTO, PhilCare

By leveraged Proto's cutting-edge AI solutions and API integration, PhilCare was able to address the challenges of their customer support operations. By providing more convenient and accessible healthcare services to its members, Philcare is improving overall healthcare membership satisfaction and reducing the risk of losing customers due to long wait times or lack of response.

The implementation of Proto's AICX solution is part of PhilCare's strategy to ensure world-class healthcare services for its Filipino clients while leveraging innovative solutions. Proto is proud to assist Philcare in its mission of making wellness more efficient and accessible for everyone through technology.

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