US 2026/0189656 A1 · SYSTEMS AND METHODS FOR USING MACHINE LEARNING IN HEALTHCARE ENROLLMENT

Abstract

Disclosed herein are, among other things, systems and methods that use machine learning models, such as large language models, for analysis (e.g., predictive analysis) of calls between an agent and caller and/or feedback generation for calls between an agent and caller. Such calls may be made by callers who are interested or potentially interested in an offering, such as a program, product, or service. Feedback may be presented (e.g., immediately) after a call completes and/or during a call, for example in near real-time. Systems and methods described herein may use and/or identify features and/or one or more predetermined (e.g., preferred or optimal) criteria (e.g., threshold(s), value(s), range(s), pattern(s), or a combination thereof) for analysis and/or feedback generation.

Claims26

Dependent claims

A method for analyzing an agent-caller enrollment call in near real-time and generating a feedback report, the method comprising:

(a) receiving, by a processor of a computing device, audio data corresponding to a call between an agent and a caller;
(b) converting, by the processor, the audio data to textual data;
(c) automatically applying, by the processor, a set of predefined large language model (LLM) prompts to the textual data using a first LLM, each of the prompts directed to assessing one or more members selected from the group consisting of compliance, quality, clarity, adherence to one or more guidelines, and accuracy of performance of the agent during the call;
(d) receiving, by the processor, one or more LLM-generated responses corresponding to the prompts from the first LLM;
(e) generating, by the processor, a feedback report for the call based at least in part on the LLM-generated responses;
and
(f) providing, by the processor, the feedback report for presentation to the agent and/or one or more authorized stakeholders.

4 more elements

Dependencies are inferred from the claim text.

Systems and methods for using machine learning in healthcare enrollment

Life of this patent

Systems and methods for using machine learning in healthcare enrollment

Life of this patent

Abstract

Claims26