MEDICAID RECERTIFICATION SOLUTION
AI AGENT

Automated Outreach Agent

Multi-channel communication system that contacts at-risk beneficiaries through SMS, phone calls, and emails in their preferred language to prevent coverage lapses.

82% Contact Success
12 Languages
3.2M Messages/Month

CHANNEL PERFORMANCE

SMS

89%

Phone

76%

Email

62%

Core Responsibilities

Multi-Channel Messaging

Orchestrates outreach across SMS, voice calls, emails, and WhatsApp based on patient preferences and contact success rates.

Language Localization

Automatically detects and communicates in patient's preferred language with culturally appropriate messaging.

Personalized Campaigns

Tailors message content, timing, and frequency based on patient demographics, history, and response patterns.

Communication Channels

SMS Messaging

Primary channel with highest engagement

  • Two-way messaging for immediate responses
  • Link shortening for easy access to forms
  • Appointment reminders and confirmations
  • Document upload links with QR codes

Voice Calls

AI-powered conversational outreach

  • Natural language processing in 12 languages
  • Warm transfers to live agents when needed
  • Call scheduling based on patient availability
  • Voicemail detection and custom messages

Email Communications

Detailed information delivery

  • HTML templates optimized for mobile
  • Secure document attachments
  • Tracking pixels for engagement metrics
  • One-click action buttons

WhatsApp Business

High engagement messaging

  • Rich media support for documents
  • End-to-end encryption for HIPAA compliance
  • Quick reply buttons for easy responses
  • Group messaging for family notifications

Intelligent Campaign Strategy

Optimal Timing

AI determines best contact times based on historical response rates, avoiding early mornings, late nights, and cultural/religious observances.

Channel Escalation

Starts with least intrusive (SMS), escalates to phone calls if no response within 48 hours, follows up with email for documentation.

Family Involvement

With consent, includes authorized family members or caregivers in outreach to improve response rates.

Cultural Adaptation

Messages are culturally adapted beyond translation, considering health literacy levels and cultural sensitivities.

Campaign Dashboard

Active Campaigns

4,237 Patients in Outreach

Today's Activity

SMS Sent

1,247

Calls Made

423

Responses

892

Response Rate by Language

English

85%

Spanish

78%

Mandarin

71%

System Integrations

Twilio

SendGrid

Amazon Connect

WhatsApp Business API

Google Cloud Translation

Microsoft Azure Speech

Salesforce Marketing Cloud

HubSpot

AI-Powered Medicaid Enrollment & Healthcare Access | HeyMedicaid