38% call containment in 90 days for a regional healthcare provider — healthcare-safe conversational AI
A regional healthcare provider needed to contain rising call volume for scheduling, refills and pre-visit intake without adding agents. pronix.ai deployed Kore.ai Agent Platform virtual agents on voice and chat with Epic integration, PHI guardrails and HITL escalation — 38% containment in 90 days with CSAT flat.
Regional healthcare provider, 42 clinics · Kore.ai Agent Platform · Epic · Amazon Connect
- Client
- Regional healthcare provider, 42 clinics
- Industry
- Healthcare Providers
- Platform
- Kore.ai Agent Platform · Epic · Amazon Connect
*Representative outcome; results vary by client, scope and platform configuration.
The challenge
Call volume was up 34% year over year, driven by appointment scheduling, medication refills and pre-visit intake. Hiring couldn't keep pace and abandon rates were climbing. Any AI rollout had to stay inside healthcare guardrails, integrate with Epic and never mis-triage a clinical symptom.
Our approach
Bounded intents, clinical guardrails
Shortlisted three intents — scheduling, refills, pre-visit intake — and put a symptom-triage classifier in front that hard-routed anything clinical to a human within two seconds.
Epic-native tool layer
Nine idempotent tool calls into Epic for appointment slots, medication lists and demographics. Every write journaled to Epic audit for compliance.
Voice + chat from day one
Same Agent Platform bot flow deployed to Amazon Connect voice and the patient portal chat — one authoring surface, two channels live together.
PHI guardrails and HITL
PII/PHI masking on every prompt, topic-scope firewall, and a warm handoff pattern that shipped the full transcript context to the agent — no repetition.
“Our access center finally has room to breathe — and patients are getting appointments booked at 11pm on a Sunday.”
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Kore.ai programs, delivered and measured
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Brief details →AI for patient access, clinical documentation and revenue cycle
Care navigation, patient access, referrals, documentation and RCM — automated with governed AI on Epic and Oracle Health integration patterns.
Brief details →Cutting claim-triage cycle time by 62% at a top-5 US health insurer
Read →Omnichannel conversational AI at a large healthcare provider — one bot across voice, web, SMS and app
Read →Agent assist across 900 seats at a healthcare provider — 22% AHT reduction with healthcare guardrails
Read →Illustrative case study. Scenarios, metrics, quotes and client details are representative composites based on Pronix engagements and industry benchmarks unless a named client is shown with written consent. Outcomes vary by client, scope, data quality and platform configuration. Nothing on this page is a guarantee, warranty or professional advice. See our Terms of Use for the full disclaimer.
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industryHealthcare Providers — routed to this team