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400K

patients

48K

affiliated doctors

1.6K

accredited hospitals

1.23M

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

About PhilCare

PhilCare is one of the Philippines’ 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 with access to world-class health services. Today, PhilCare continues to focus on patient care with innovative and technology-enabled services that make healthcare more accessible.

About Proto

Proto is the leader for 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 patient experience, protection, and lifetime value across 20+ emerging markets.

Problem

PhilCare relied on patient support via hotline and email. But the growing number of incoming patient requests, which sometimes reached thousands per month, became difficult for human agents to handle. Most of the inquiries were simple questions such as inquiries about 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 patient satisfaction, posing a risk to PhilCare's membership renewal rates.

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

Solution

PhilCare evaluated a few solutions and vendors. After a one-month trial, Proto's multilingual chatbot platform surpassed PhilCare's expectations – reducing patient query resolutions to 2 seconds and human agent reliance to 52%.

The chatbot (Phil) was deployed on PhilCare's website and Facebook Messenger, allowing their 400,000+ patients all over the Philippines to receive instant responses to frequently asked queries, instead of waiting for responses over the phone or via email.

Phil is integrated into PhilCare's internal systems to answer requests such as:

  • Checking accredited hospitals and clinics
  • Checking affiliated physicians
  • Finding out about plan coverage
  • Claiming reimbursements
  • Generating letters of authorization for online or face-to-face consultations

In the coming months the chatbot will be expanded and trained based on Proto proAnalytics to find out what 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:

1.23M

messages exchanged between customers and multilingual chatbot

5,710

inquiries on plans and benefits

3,681

inquiries on accredited clinics

2,384

inquiries on clinic locations

2,345

inquiries on accredited doctors

69K

chats handled

1.95s

response time

Approach

Conclusion

By leveraging Proto's cutting-edge AI solutions and API integration, PhilCare was able to address the challenges of their patient support operations. Patients have convenient and accessible healthcare services, improving overall healthcare membership satisfaction and reducing the risk of losing patients 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.