Health Plans: Achieving the Competitive Edge by Learning from Each Other

For many health plans, the Affordable Care Act has forced the industry into revamp mode. The market is more competitive and unforgiving than it has ever been. People have more options when it comes to their health plans and they aren’t afraid to change. Members are now true ‘customers’, and most health plans know they have to take a different approach when it comes to their customer service strategies.

One of my favorite events to attend each year is the Blue National Summit. It’s a consolidation of peers and organizations with the same goals and objectives, working together to find the best solution for their members. There is no mention of competition or weariness around sharing their secrets. They all have the same mission – providing superior member experiences to retain existing business and grow new business, and there’s so much to be learned.

As I spent time with some of the Blue Cross Blue Shield organizations, I saw that many of their initiatives were communications and process oriented. Although most of them didn’t know where to start with the transformation of this experience, they quickly started relating back what they’ve seen with competing companies and other industries. The discussions turned to what their expectations would be as customers, and how they could meet their own demands. Many of the solutions discussed turned out to be things they already had in place, but needed to be revaluated.

  1. Business Process Automation – At the root of every interaction lies a process. Blending network inquiries, coverage changes and billing processes with communications allows for more efficient request handling. When a member calls in, take what you know about them (previous interactions, life events, etc.) to better gauge what they may be calling about. This creates a more personalized experience, while also increasing first call resolution and cutting back handle times.
  2. Collaboration – One of the main member complaints is the lack of communication between the payer and provider. Through EMR integrations and collaboration tools, provider/payer/patient transparency (in a secure fashion) evolves, and the overall member experience is improved naturally. Everyone has the information they need, when they need it.
  3. Self-Service – Many industries are starting to figure out the art of making self-service a preferred communications channel. Through member portals, intelligent IVRs and more seamless integration with back-end systems, self-service can help free up resources for common inquiries like claim status, document requests and coverage details, not to mention giving your business a 24-7 support feel without the resources.
  4. Cloud-based Technologies – Cloud communication solutions not only free up IT resources, but allow for scalability and growth. With the ACA, the health plan business has only increased, meaning prospect and member inquiries are increasing as well. Cloud communications allow plans to implement various solutions and resources easily when and where they are needed, recognizing that the demand of the business is changing constantly.

Is your organization starting to take a look at any of these solutions? How are you leveraging what other industries are doing as a starting point for your own customer service initiatives?

Four Tips to Take Your Customer Service from Good to Great

In the spirit of Customer Service Week, I’ve been reflecting on what goes into stellar service. Based on my professional experience speaking with companies about their customer service goals and challenges, I’ve developed the following four customer service tips that every contact center should make a priority.

Tip #1: Be customer-centric. This seems obvious, but it’s surprisingly rare that companies actually do it. It also has less to do with adopting sophisticated technology than it does with a change in perspective and protocols. Imagine you’re a contact center for a company that just suffered a loss of service, which negatively […]

“We Don’t Know What We Don’t Know”: Uncovering Ways to Increase Utility Customer Engagement

“We don’t know what we don’t know, so how do we know?”

I had the pleasure of spending a day with a customer service manager and others at a gas/electric utility a couple of weeks ago. My favorite thing was hearing someone say that sentence.

It’s a phrase that could set your head spinning. But it was refreshing to hear how curious they were to understand and learn what their customers want from a utility in customer service. The excitement on my part was hard to contain. We all know it can be daunting to change, but the world is […]

How to gain and keep Gen Y loyalty

Gen Y’s constant connectivity through various channels allows them to direct the way brands should manage their customer service. So what does Generation Y want in terms of customer service? Retailers that are one step ahead.

Unique Personalization Loyalty programs and personalized perks are just two of the expectations from Gen Y. Retailers must think about the “something extra” for Gen Y. For example, Beachbody offers “Beach Body Club” in which consumers get discounts on workout items, along with free support and advice from health coaches. The customer gets personalized coaching while the retailer guides them on what to purchase […]

Life on a Seven-Second Delay

One infamous wardrobe malfunction in the 2004 Super Bowl made the seven-second broadcast delay a household term. A seemingly negligible amount of time, seven seconds gave television executives the feeling of security, the knowledge that they could cut the video feed or bleep the audio before it went out to millions of viewers.

But imagine what life would be like if our vision or hearing was limited by that seven-second delay. Forget about catching your smartphone before it hits the floor; according to Isaac Newton, that screen’s already been cracked for six seconds and change. Walking around? Take one step, […]

Simulation modeling and Madden: Understanding “What if” analyses through football

Many years ago, I got my first promotion for drawing a simple graph.

I had been asked a question: Given changes we were expecting at our airline, what should be our servicing strategy?

That question is the sort of question that you would ask a $500/hour consultant, and I certainly wasn’t one of those. But my boss knew that I had built a discrete-event simulation model of the contact center network, and he felt it was time to take the model out for a spin.

Many of you haven’t heard of discrete-event simulation modeling, but if your home is like […]

How One Company Used their Best Asset – Their People

You can help drive a culture of inclusion and collaboration or you can let your team descend into constant reactive mode. If you ignore what your people are saying, this can create a siloed environment which can directly impact your customer service.

An inspiring moment for me was listening to what our customer Ambit Energy, a top electricity and gas provider, has accomplished by listening to its employees and turning those insights into action.

Ambit reached out to its employees for ways to improve, and then followed through, making changes to its processes. CRM system improvements decreased an average call […]

Collection Analytics: How to save money with counterintuitive data

One of my more interesting jobs was as a manager of a credit card collections analytics group. We were tasked to produce all sorts of cool analytics, from when to schedule collectors to how to segment the delinquent customers to how to manage the collections dialer. It was fun.

Being someone who hadn’t grown up in collections, I was able to ask all sorts of stupid questions — to challenge the “traditional” way of operating. And we found some cool “traditions” that should be re-evaluated. One of the more nuanced piece of analyses we performed was to determine the priority […]

Want happy customers? Get intentional about your experience

With today’s technology, feeding customers’ multi-channel expectations isn’t about enabling many channels of communication; the struggle lies in managing the people, processes, and technology that deliver the experience to your customers.

If you boil it down to its simplest terms, the customer sees and experiences you as one entity. They do not think of your marketing team or your customer service department; they think Disney, Apple, Google, Comcast, and Verizon. Every interaction with every employee, product, or service combines to create that customer’s “experience.”

Whether you define the experience you will deliver or not, customers will have expectations. If you […]

Lessons from Lego: Confessions of an enterprise collaboration addict and toddler mom

As first-time parents, my husband and I try to be wise in our toy purchases. (Experienced parents: please stop laughing.) But it’s become clear that most toys aren’t designed with both parents and toddlers in mind; most seem to fall into one of several categories. As I began to define the different categories of toys in my head after cleaning up a particularly rowdy play session, I realized they looked surprisingly similar to the enterprise collaboration and communication marketplace (but more on that soon):

Best of Breed – This toy does one thing well, but that’s it. You can’t expand […]