TPA

Automated PPMC Appointment Lifecycle Management at Scale

A leading IRDAI-licensed TPA manages thousands of Pre-Policy Medical Check-up (PPMC) appointments daily across multiple regions. As appointment volumes scaled, ensuring timely proposer confirmations, reducing no-shows, and coordinating phlebotomist visits became a critical challenge directly impacting underwriting timelines, policy issuance speed, and operational efficiency.

Desible.ai partnered with the TPA to introduce an AI voice engagement layer that automated the entire PPMC appointment lifecycle from reminder calls to show/no-show verification and phlebotomist escalation delivering measurable operational outcomes and enterprise-grade compliance.

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18,000+

calls handled daily

89%

reduction in manual follow-up efforts

33%

increase in PPMC completion rate

99.9%

platform uptime

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TPA Workflow Diagram

The Challenge

High PPMC No-Show Rates

A significant percentage of scheduled pre-policy medical check-ups resulted in no-shows, directly delaying underwriting decisions and policy issuance for insurers.

Manual Confirmation Calls

Operations teams spent hours each day calling proposers to confirm, remind, or reschedule PPMC appointments consuming bandwidth that should have been directed toward exception handling and insurer coordination.

Phlebotomist Coordination Delays

When field partners were delayed or unavailable, there was no proactive communication to proposers, resulting in inbound complaint calls, missed appointments, and repeated scheduling cycles.

No Real-Time Tracking

Ops managers lacked real-time visibility into PPMC appointment statuses, no-show patterns, and call outcomes, making it difficult to report accurately to insurance partners or intervene early on at-risk cases.

Objective: To automate routine PPMC appointment communication end-to-end while ensuring speed, accuracy, and full compliance with IRDAI and DPDPA 2023 guidelines.

The Solution

Desible.ai deployed a 24/7 AI Voice Agent designed to manage the complete PPMC appointment lifecycle autonomously. Key capabilities included:

1

Reminder Calls

Proposers are called the day before and one hour before their scheduled PPMC to confirm, reschedule, or cancel ensuring no case goes unconfirmed and no phlebotomist dispatch is wasted.

2

Show / No-Show Verification

Post-visit, the AI automatically contacts proposers to verify whether the medical check-up was completed, capturing outcomes and feedback in real time.

3

Phlebotomist Escalation

If the field partner is delayed, the AI calls the phlebotomist directly, captures the delay reason and revised ETA, and proactively updates the proposer before they call the helpline.

4

Final Show / No-Show Resolution

Every PPMC case is closed with a verified disposition such as completed, rescheduled, no-show, or escalated with complete audit trails logged to the TPA system for insurer reporting.

The Outcome

By implementing Desible.ai's AI Voice Agent, the TPA was able to:

1

Reduce PPMC no-shows through proactive, timely reminder calls

2

Free up ops team bandwidth previously spent on manual follow-ups

3

Increase PPMC completion rates with end-to-end lifecycle automation

4

Accelerate underwriting timelines by ensuring faster, verified medical check-up completions

"Managing thousands of PPMC appointments manually every day was unsustainable. Since deploying Desible.ai, the entire lifecycle runs autonomously, no-shows are down, insurer turnaround has improved, and our ops team focuses only on exceptions. It is now a core part of how we operate at scale."

Head of Operations

Leading IRDAI-Licensed TPA

18,000+

calls handled daily

89%

reduction in manual follow-up efforts

33%

increase in PPMC completion rate

99.9%

platform uptime

Book a Demo

Desible.ai enables enterprise platforms to automate large-scale, compliant, human-like voice interactions, driving faster conversions and measurable business outcomes.