How Humana Uses IBM Watson to Handle 7,000+ Voice Calls Daily at One-Third the Cost
Humana replaced its legacy IVR system with an IBM Watson-based conversational voice agent that handles 7,000+ provider calls daily, completing inquiries in 2 minutes at one-third the previous cost.
Impact
~66% (1/3 cost)
Cost Reduction
90-95%
Accuracy Rate
7,000+
Daily Voice Calls Handled
~2 minutes
Inquiry Completion Time
Challenge
Legacy IVR system transferred over 60% of calls to human agents at high cost. Over one million provider calls monthly, with most callers bypassing the IVR for outsourced call centers.
Solution
Watson-based conversational voice assistant combining seven language models and two acoustic models with speech customization to understand caller intent and deliver eligibility, benefits, claims, and authorization information.
Tools & Technologies
What Leaders Say
“Providers can now call into the Watson-based solution and complete an inquiry in about two minutes without waiting to reach a call center representative.”
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Full Story
Humana, one of America's leading health insurance companies, was spending heavily on its interactive voice response (IVR) system that transferred over 60% of calls to human agents. With more than one million provider calls monthly, most callers bypassed the IVR entirely, reaching outsourced call centers at significant cost. Administrative staff needed faster access to routine pre-service questions about member health plan benefits and eligibility.
Humana partnered with IBM to develop a Watson-based conversational voice assistant combining multiple Watson applications on IBM Cloud with watsonx Assistant for Voice on-premises. The solution uses seven language models and two acoustic models with speech customization to understand caller intent, verify access permissions, and deliver specific eligibility, benefits, claims, authorization, and referral information.
The results were impressive: the system achieves 90-95% sentence error rate accuracy and handles inquiries at approximately one-third the cost of the previous system. It processes over 7,000 voice calls from 120 providers per business day, with typical inquiry completion in about 2 minutes — compared to the previous method that required 7-page fax responses.
AWS