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    AI-Powered Appeals and Grievance Intake with Amazon Connect

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    An AI-powered speech-to-speech Appeals & Grievance intake solution built on Amazon Connect, Amazon Lex, Amazon Q, Nova Sonic, AWS Lambda, and Amazon S3 to modernize healthcare and enterprise contact center operations. The solution enables intelligent voice-based intake using real-time conversational AI, combining structured business workflows through Amazon Lex with generative AI capabilities powered by Amazon Q and Nova Sonic. It automates intent recognition, spoken information capture, knowledge retrieval, case summarization, and backend integrations with systems such as Pega. Integrated knowledge bases stored in Amazon S3 provide contextual and policy-aware responses, while AWS Lambda orchestrates secure backend workflows and enterprise integrations. The platform reduces manual effort, accelerates case intake processing, improves response accuracy, and enhances customer and agent experiences through natural speech-driven interactions.

    Overview

    This solution transforms traditional appeals and grievance (A&G) intake into an AI-powered, speech-to-speech platform using AWS. Built on Amazon Connect, it combines Amazon Lex workflows with generative AI from Amazon Q and Nova Sonic for natural, real-time voice interactions.

    Key Differentiators:

    • Intelligent IVR + AI Intake: Replaces legacy menus with a dynamic Voice + AI experience, guiding customers through complex A&G journeys.
    • Voice Capture & Verification: Automated conversational bots securely verify caller identity and structure complaints.
    • Automated Case Creation: Generates structured summaries and injects cases directly into the A&G system from the voice interaction.
    • Seamless Integration: Connects directly into existing workflows like Pega.

    Business Outcomes:

    • 60% reduction in call handling time
    • ~40% reduction in manual effort
    • ~30% reduction in data errors
    • Improved patient experience and expanded channels

    Highlights

    • Operational Efficiency & Cost Optimization Significantly reduces average handle time and manual effort by transforming traditional intake into an automated voice session. The AI assistant streamlines customer verification and data capture, minimizing operational friction and lowering overhead costs.
    • Next-Generation IVR + AI Architecture Combines structured Amazon Lex bot workflows with generative AI from Amazon Q and Nova Sonic to deliver an Intelligent IVR + AI experience. This cloud-native design enables both guided business processes and natural-language interactions, ensuring enterprise scalability and seamless integration into existing A&G workflows.
    • Backend Workflow Automation Securely orchestrates integrations with enterprise systems like Pega using AWS Lambda. The solution automates case creation, validation, and workflow processing while generating contextual interaction summaries for downstream case management.

    Details

    Delivery method

    Deployed on AWS
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