International Journal on Science and Technology

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Transformative AI for Healthcare Customer Service: Auto-Documentation of Compliance-Critical Questionnaires

Author(s) Leela Naga Sai Vamsi Krishna Dogiparthi
Country United States
Abstract Over the last two decades, the population across the world has increased exponentially so as the number of healthcare requests. Especially, post-COVID the number of customer service calls for various healthcare related queries across the healthcare providers has increased by 65% [1]. The staffing shortages have made it harder for the providers to answer every call in a defined time. Also, 60% of users reported that they have higher waiting times, which is very frustrating and doesn’t leave a pleasant impression on the users’ mind. In our survey with customer care representatives across the various healthcare providers showcased that the majority, 75% - 80% of the time spent on a call is taken to document compliance critical questions which are manual and tedious. This paved path to our study on developing an AI-powered live transcription agent that simultaneously converts voice interactions to text, extracts answers to predefined clinical/billing questions, and provides real-time feedback to healthcare customer service agents regarding unanswered queries. This work establishes a new paradigm in the healthcare customer service realm with possibilities of transforming the healthcare infrastructure across the nation.
Keywords Natural Language Processing (NLP), Natural Language Understanding (NLU), Sentiment Analysis, User Intent Recognition, Speech to Text, Prompt Engineering, Plugins, Responsible AI, Encryption at rest, Compliance, HIPAA
Field Computer > Artificial Intelligence / Simulation / Virtual Reality
Published In Volume 16, Issue 2, April-June 2025
Published On 2025-06-22
DOI https://doi.org/10.71097/IJSAT.v16.i2.6466
Short DOI https://doi.org/g9q4cf
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