CA Healthcare Provider Scales Patient Access with AI Agents

Overview

A mission-driven healthcare provider serving diverse communities across California partnered with Kore.ai to modernize patient access and support during a period of rapid expansion. Rising call volumes, multilingual support needs, and limited staffing flexibility made it increasingly difficult to deliver timely assistance across appointment scheduling, lab inquiries, pharmacy refills, and other routine workflows.

Built on Kore.ai’s AI for Service platform and enabled by AI for Healthcare pre-built AI Agents, the organization deployed an intelligent, automated patient-support agent designed to manage high-volume, repeatable inquiries with speed and consistency. The AI agent now handles routine questions across multiple languages, provides support beyond standard clinic hours, and directs more complex needs to the appropriate care teams.

The result is a more responsive, scalable patient experience that reduces operational strain while upholding the organization’s commitment to high-quality care.

The Challenge

As the healthcare provider expanded its coverage and patient demand grew, the organization faced increasing pressure on its human agents to manage high call volumes, complex scheduling needs, and multilingual support with limited staffing.

Key pain points included:

• Heavy reliance on time-consuming, manual workflows
• Limited multilingual and after-hours support options
• Rising handle times and growing agent workload
• Staffing constraints during peak periods
• Frequent transfers and inconsistent routing
• Care teams spending time on routine administrative tasks

These challenges made it difficult to deliver timely, consistent patient support at scale.

The Solution

The organization implemented Kore.ai’s AI for Service agentic AI platform, enhanced by AI for Healthcare pre-built AI Agents, to rapidly deploy a customizable AI agent tailored to patient communication needs and experience standards.

Designed to support high-volume workflows, the AI agent automates common inquiries, assists patients across multiple languages, and provides support beyond standard operating hours, while ensuring seamless and clinically appropriate handoff to human agents when needed.

With the AI agent in place, the healthcare provider was able to:

• Automate routine tasks, including appointment scheduling and updates, sending notifications and reminders, lab result inquiries, pharmacy refill requests, and referral management
• Deliver multilingual and after-hours support, improving access for diverse patient populations
• Reduce handle times by instantly resolving repetitive questions and eliminating manual steps
• Increase staffing flexibility by absorbing call-volume fluctuations without adding headcount
• Streamline routing and minimize unnecessary transfers, directing patients to the right resource or care team more efficiently
• Offload high-volume administrative tasks, allowing human agents and care teams to focus on complex or sensitive patient needs

Through this combination of customizable AI agents and healthcare-specific capabilities, Kore.ai enabled a more accessible, efficient, and patient-centered support experience.

Business Impact

By deploying Kore.ai’s AI for Service platform and implementing customizable AI Agents, the healthcare provider achieved measurable improvements in operational efficiency, patient access, and overall service responsiveness. Automation now handles the majority of routine inquiries, allowing the organization to manage increasing demand without expanding staff.

As adoption increased, these gains translated into clear outcomes:

• Significant containment gains, reducing operating costs
• $3.2M in revenue enabled through automated appointment scheduling
• 468% ROI since program inception
• 24% containment rate, with continued growth expected as workflows expand

These results demonstrate the compounded value of extending agentic automation across high-volume healthcare workflows.

The Kore.ai Advantage

Kore.ai provides an enterprise-grade foundation designed for the scale, regulatory requirements, and clinical workflow complexity common across healthcare organizations. The AI for Service agentic AI platform, combined with AI for Healthcare, enables providers to automate high-volume patient interactions, deliver consistent multilingual support, and integrate seamlessly with EMR and backend systems.

With built-in security, governance, and compliance, Kore.ai helps healthcare organizations modernize patient access while maintaining trust and clinical integrity—offering a proven model for adopting agentic AI responsibly at scale.