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Shiva Chaitanya

Publications and source records attributed to Shiva Chaitanya.

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INSURE-Dial: A Phase-Aware Conversational Dataset & Benchmark for Compliance Verification and Phase Detection

Administrative phone tasks drain roughly 1 trillion USD annually from U.S. healthcare, with over 500 million insurance-benefit verification calls manually handled in 2024. We introduce INSURE-Dial, to our knowledge the first public benchmark for developing and assessing compliance-aware voice agents for phase-aware call auditing with span-based compliance verification. The corpus includes 50 de-identified, AI-initiated calls with live insurance representatives (mean 71 turns/call) and 1,000 synthetically generated calls that mirror the same workflow. All calls are annotated with a phase-structured JSON schema covering IVR navigation, patient identification, coverage status, medication checks (up to two drugs), and agent identification (CRN), and each phase is labeled for Information and Procedural compliance under explicit ask/answer logic. We define two novel evaluation tasks: (1) Phase Boundary Detection (span segmentation under phase-specific acceptance rules) and (2) Compliance Verification (IC/PC decisions given fixed spans). Per-phase scores are strong across small, low-latency baselines, but end-to-end reliability is constrained by span-boundary errors. On real calls, full-call exact segmentation is low, showing a gap between conversational fluency and audit-grade evidence.

cs.CL

All Required, In Order: Phase-Level Evaluation for AI-Human Dialogue in Healthcare and Beyond

Conversational AI is starting to support real clinical work, but most evaluation methods miss how compliance depends on the full course of a conversation. We introduce Obligatory-Information Phase Structured Compliance Evaluation (OIP-SCE), an evaluation method that checks whether every required clinical obligation is met, in the right order, with clear evidence for clinicians to review. This makes complex rules practical and auditable, helping close the gap between technical progress and what healthcare actually needs. We demonstrate the method in two case studies (respiratory history, benefits verification) and show how phase-level evidence turns policy into shared, actionable steps. By giving clinicians control over what to check and engineers a clear specification to implement, OIP-SCE provides a single, auditable evaluation surface that aligns AI capability with clinical workflow and supports routine, safe use.

cs.AI