Aivo > Case Studies > Transforming Healthcare Support with AI: A Case Study of Sipssa Medicina Privada

Transforming Healthcare Support with AI: A Case Study of Sipssa Medicina Privada

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Technology Category
  • Sensors - Camera / Video Systems
Applicable Industries
  • Finance & Insurance
  • Healthcare & Hospitals
Applicable Functions
  • Sales & Marketing
Use Cases
  • Search & Rescue
  • Time Sensitive Networking
About The Customer

Sipssa Medicina Privada is a leading prepaid health insurance company in Argentina. The company is committed to resolving all kinds of member queries through its AI-powered conversational bot, Sipssi, and even provides immediate assistance in emergency situations. Sipssa currently has over 35,000 members, 400 healthcare providers, and operates 6 branches in Cordoba, Argentina. The company's primary goal is to satisfy its members' needs and expectations through a team of highly qualified professionals.

The Challenge

Sipssa Medicina Privada, a renowned prepaid health insurance company in Argentina, was grappling with the challenge of reducing response times for its members. The company was experiencing delays of up to 48 hours in responding to queries through phone and email channels. The need for 24/7 availability and immediate responses was paramount to enhance their relationship with members. The company aimed to reduce pending messages, provide round-the-clock customer service, receive online referrals from potential members, rate representative service in customer experience, improve customer service by providing adequate information, optimize and measure response times in each process, and systematize processes without needing representative assistance.

The Solution

To address these challenges, Sipssa developed a conversational AI bot, Sipssi, powered by Aivo's technology. An interdisciplinary team was formed to implement the bot, identify issues that could be fully addressed by Sipssi, and those that would require human intervention. The bot was designed to provide two types of services: administrative service for members and commercial service for non-members. The bot was implemented on WhatsApp, Facebook, and the company's website, with WhatsApp being the most used channel. Sipssi assists customers with authorizations, logging in to the member portal, making health insurance payments, recruitment form for potential interested parties, refunds, and using the app. To encourage the adoption of these automatic channels, Sipssa carried out email marketing campaigns, promoted through social networks, YouTube tutorial videos, app notifications, in-branch flyers, and IVR with their 0-800 number.

Operational Impact
  • The implementation of the AI bot, Sipssi, has significantly improved Sipssa Medicina Privada's customer service. The bot's 24/7 availability and immediate response capability have been instrumental in providing timely assistance, especially in emergency situations. The bot's ability to respond to different messages from customers going through emergencies has been a game-changer. The bot has also played a crucial role in Sipssa's strategy, with 90% of inquiries being automated through WhatsApp. The bot has not only improved response times but also helped in capturing leads and complementing the sales strategy. The company has also seen a wide adoption of this technology among its audience.

Quantitative Benefit
  • Sipssi resolves an average of 10,000 inquiries per month.

  • The average service time is 3:57 minutes with an average efficiency of 87%.

  • 90% of these inquiries are automated through WhatsApp.

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