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GiftHealth is a technology-driven healthcare platform that streamlines administrative processes between prescribers, manufacturers, and patients, removing barriers to prescription care. Leveraging automation and AI, GiftHealth makes specialty medicine and procedures more accessible and affordable for patients while easing the administrative load on prescribers.
With rapid growth, the team initially projected a need to scale up to 2,000 representatives within two years to manage contact center operations. However, with the introduction of Retell, that plan was scrapped as the team recognized the potential of scaling their contact center using AI.
A veteran in the healthcare space, CEO John Romano co-founded GiftHealth with a mission to make prescription care more accessible and affordable. As a non-prescribing pharmacy, GiftHealth offers an extra layer of patient support between prescribers’ offices and partner pharmacies. “GiftHealth makes the process really simple for doctors, who just go into their EHR system,” Romano explains. “Then the patient journey starts with automation. As soon as we receive the script, the patient gets a text message and we start onboarding.”
Supporting prescribers, especially in the gastroenterology field, became increasingly crucial as the business expanded. Senior Engineer Jonathan Adly recognized that a voice AI solution could relieve the call burden on GiftHealth’s PCRs, but he was aware of the challenges. “I have implemented this kind of stuff manually before Retell AI was around,” he explained. “It was extremely painful.” For any solution to work seamlessly, the GiftHealth team had several key requirements:
GiftHealth’s PCRs provided after-hours support to help patients preparing for procedures like colonoscopies, which typically start the night before. “Patients might call their doctor with questions, disrupting their personal time,” Romano explains. While many inquiries were similar, scaling operations to manage growing call volumes would have required a significant increase in PCRs.
For GiftHealth users dealing with serious health concerns, receiving accurate and timely answers to their inquiries is essential. GiftHealth’s trained PCRs offered significant value to prescribers offices by handling these calls. “Prescribers can approve an FAQ and patients can then call GiftHealth instead of their doctor’s office,” Romano explains. Any voice AI solution needed to uphold these high standards.
Since some patient issues require escalation, it was essential for any solution to identify and escalate critical concerns. "We wanted to answer as many calls as possible, but we always maintain a human component," Romano explains. "We also have a team of pharmacists because some calls need to be handled by a clinical professional."
GiftHealth's mission is to save its users money, making organizational cost optimization a core part of their model. Drawing from his past experience, Adly knew that building a voice AI solution in-house would be costly. “You need a large engineering team to support it,” he notes.
Adly also understood that maintaining a voice AI system required constant management, given the rapid evolution of AI technology. “If you’re going to build AI in-house, it has to be your core competency and you cannot do anything else,” Adly says. GiftHealth needed to focus on the rest of their platform as well.
Retell AI provided GiftHealth with an easy-to-manage AI solution that greatly improved operational efficiency. By automating responses and handling 45% of inbound calls without human intervention, Retell AI became the first line of support, enabling GiftHealth to scale their operations without expanding their team. This solution was also well-received by prescribers. “When AI answers calls, it frees up doctors’ offices to do more for their patients,” Romano says.
Retell AI is able to address common patient questions and concerns, providing a better experience for both patients and prescribers. “We have a knowledge base that we distilled into a prompt,” Romano explains. “If the AI can answer based on its prompt, then it takes care of it. If not, the call goes to a human.”
"The great part about AI too is you can put so many guardrails up to make sure it's saying the right thing to patients.”
GiftHealth implemented Retell AI as “more or less the first line of defense as a patient touch point,” Adly explains. After eight weeks of training, the AI was successfully resolving 45% of issues without human input. “These are great numbers, given the scale that GiftHealth operates at. We haven’t even fully expanded it to all our lines yet,” Adly shares.
“We shield doctor offices from as many phone calls as possible. That was a big pain point for them and they’re super happy with the results.”
Retell AI now supports nearly 50% of GiftHealth’s patient user base as the first step in their customer journey. GiftHealth managed to repurpose 40% of PCRs for higher-level tasks, while doubling their call volume in six-months. This rapid pace of growth initially led Adly and colleagues to contemplate a significant expansion of their call centers.
“No-one is envisioning a 2,000-person call center now. A year ago, it seemed that’s where we were headed.”
When evaluating voice AI platforms, Adly focused on “the core competency of the engineering team.” He assessed about half a dozen options before choosing Retell AI. “I have not been disappointed,” he affirms.
“AI is moving super fast. Something new comes up, and two weeks later it’s integrated in Retell’s platform.”
Initially, the engineering team managed the entire pipeline. After 12 weeks—enough time to build confidence in the voice AI solution’s maintenance and expansion—90% of the work was handed off to a product specialist with domain expertise. “It could have happened a lot earlier,” Adly notes.
“The product team owns the Retell AI dashboard and prompting. Whenever something needs to be hooked up, they loop in the engineering team. But day-to-day work is handled by product.”
Using Retell AI as an adjunct to its call center, GiftHealth unlocked significant organizational efficiency, optimizing resource use and boosting operational capacity.
“Our numbers show that 45-50% of calls are completely resolved by Retell AI without ever touching a human. We haven't even fully expanded it to all our lines yet.”
-Jonathan Adly, Senior Engineer
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