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Our predictive modeling engine can: Analyze data in real time Predict top reasons for the call Use that prediction to route the member to appropriate self-service options or to connect the member to the correct member support advocate, avoiding multiple transfers Key results: AI accurately predicts the intent for more than 50% of these calls. 11% of calls were resolved through self-service, eliminating the need for agent intervention, and approximately 300K follow-up calls were eliminated annually through improved member intent capture. In 2025, 80% of potential member issues identified by AI were resolved without a callback or escalation. That means less friction for members, lower operational burden and more capacity for advocates to focus on highervalue, complex cases

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Xu Z, Chen S, Liu R, Chen H, Xu B, Xu W