Improving Healthcare Plans Customer Satisfaction
Solix Case Study
Situation
A leading national healthcare benefit provider needed help managing inbound customer inquiries regarding benefit plans, especially during busy open enrollment seasons. They also needed highly trained, licensed agents and automated solutions to support outbound initiatives aimed at growing revenue and retaining their existing customer base in a highly competitive market.
Objectives
- Increase volume of customer sales at first contact by highlighting plan options, discussing benefit information and making well-qualified recommendations.
- Reduce agent training costs by implementing more rapid training certification programs and state-approved, per-licensing education courses.
- Safeguard customer information through strong compliance controls.
- Identify and mitigate fraud.
Challenges
- Ensuring consistency, quality, and data integrity from application intake through enrollment.
- Scaling agent resources to manage emergency and other peak periods.
- Assisting Medicare Part C and Part D members with their plans while meeting CMS requirements.
Solution
- Provided a team of trained advisors, licensed as Health & Accident Producers in dual states to increase sales and deliver superior customer service. Agents trained in 5-6 weeks vs. 10-12 weeks required by client doing it in-house.
- Continuously satisfied all HIPAA and PCI compliance requirements and ensure customer data integrity throughout the program lifecycle.
- Helped members navigate complexities associated with the Affordable Care Act and healthcare reform, from explaining subsidy and plan options to enrolling in plans.
- Employed a team of fully trained Medicare Part C and Part D Customer Service Representatives to assist members with all plan aspects (eligibility, premiums, benefit questions, provider location, claims issues) and to augment client’s current staffing as well as expand hours of operation.
Results
- Consistently achieved or surpassed all service level objectives over the 10 year partnership.
- Maintained an average customer satisfaction score of 97%, surpassing quality scoring requirements.
- Reduced agent training costs by 50%.