Health Plans are auditing only 2% of member interactions, but the other 98% are a liability
Manual QA teams can only review a fraction of member interactions. Often times it's expensive and difficult to audit non-English calls, BPO vendors, and interpreter lines.
Health plans often sample a small portion of their member calls - leading to compliance blindspots and higher grievances.
BPOs send shiny summary reports, but health plans lack assurnace of the quality of thier vendors interacting with members.
Non-English speaking members are often neglected and are more costly to audit.
CMS audits health plan call centers and the effects of infractions can be millions in fines or a downgrate in star ratings.
Audit every member interaction , coach your customer support reps, and find members at-risk of disenrolling
Integration: We connect directly to your call center infrastructure to automatically pull 100% of raw audio recordings.
Examples: Genesys, Salesforce, Intercom, Zendesk
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How it works: Specialized healthcare AI processes audio, accurately transcribing customer calls and translating non-English interactions.
Language Offerings: transcribe & translate member interactions in 32+ languages natively
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Scoring: Grade 100% of calls against strict CMS marketing and compliance guidelines. Instantly flag missing disclaimers and out-of-compliance agents.
Request DemoLearn what Mizzeto's CX solution is, how it helps health plans, and what the key benefits are for contact center QA teams.
Our AI-powered contact center QA platform automates call audits across 30+ languages, surface compliance risks and coaching opportunities in real time, and scale from sampling 1-2% of calls to reviewing 100% without hiring additional staff.
Health plans using Mizzeto typically see: reduced manual QA workload, audit coverage expanded from 1-2% to 100% of calls (including 30+ languages), faster agent feedback loops, and stronger compliance posture before CMS audits.
Results include:
- 78%+ reduction in manual QA workload
- 100% audit coverage across all member and provider
- 3-8% CSAT increase within 8 months
Mizzeto integrates with leading contact center technologies and healthcare platforms including your CRM, telephony system, and workforce management tools. This allows you to automate QA workflows, target specific call populations for review, and share compliance reports across teams with minimal disruption.
Yes - multilingual QA is core to what we do. Mizzeto audits member calls in 30+ languages, enabling health plans to evaluate interactions with LEP (limited English proficiency) populations that traditional QA programs miss entirely. This ensures consistent service quality across all member demographics while reducing Title VI and Section 1557 compliance risk.
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