Critical Call Center Metrics For Health Insurers

Robert Ayala

Robert Ayala, Director, Contact Center Services  supports Wunderman’s Call Center Optimization services; providing 20-plus years of experience in call center analytics, strategy, planning, resource development and technology. Robert is an innovative and driven leader with successful track records across many contact center initiatives including increased customer acquisition, improved client satisfaction, vendor selection and implementation, and operational gap analysis and mitigation. 

Positive customer experience is critical to the longevity of any business. A company’s call center plays a major role in creating and maintaining that positive customer experience. Historically, many top e-commerce organizations worldwide haven’t shown great interest in displaying call center phone numbers on their homepage, nor have they relied on assisted sales. However, a shift is occurring in that philosophy as businesses rely on call centers to increase revenues through improved sales and conversion, and provide insights on customer interactions otherwise unavailable.  This applies to health insurers and Medicare Advantage plans as well.

As such, measuring and understanding call center metrics is a major focus. Business models that require phone assistance for their customers should set up clear processes from the beginning to monitor call center metrics.  Managing to the five call center metrics below for your business can provide improvements where it matters most. Specific benefits we have seen with Medicare Advantage providers when focusing on these metrics include:

 Call Center Graphic

 

(please continue reading article here)


Tags: metrics, performance, member engagement, customer centric, call center, performance

Log on to Your Rise Account

Forgot your password?
Create an Account

Association Sponsors

Latest Posts

The Hidden Cost of Inadequate Health Coverage

The fuss over ObamaCare produces confusion and obscures some important realities that deserve our attention. Much of the political debate creates a polarizing force like a centrifuge, splitting the pros and the cons into opposing camps that line up behind positional opinions about whether healthcare is a right or not. For those opposed to the taxpayer shouldering the financial burden of providing healthcare to those without insurance coverage, the less the taxpayers must fork out to subsidize the uninsured the better. All the while, there is an implied assumption on the part of the entitlement crowd that just providing insurance coverage for the uninsured is the end game. In my opinion, we are all laboring under serious misunderstandings of the reality of the healthcare system and the way the costs are absorbed by society. I was looking for some solid research about the cost of the uninsured, and I came across a powerful and highly useful study from way back in 2003 when the early debate about universal coverage was just beginning. The approach they took to analyzing the problem still has significant value today, and what it says helps shed light on the misunderstandings referenced above. In a preface to the third chapter of the book Hidden Cost, Value Lost*, there is this revealing assertion from their research: The health care services received by uninsured individuals that they do not pay for themselves are picked up or “absorbed” by a number of parties, including:...
Read More

TALIX ACHIEVES HITRUST CSF CERTIFICATION TO FURTHER MITIGATE RISK IN THIRD PARTY PRIVACY, SECURITY AND COMPLIANCE

HITRUST Certification validates Talix’s commitment to meeting key healthcare regulations and protecting sensitive private healthcare information SAN FRANCISCO – November 8, 2017 – T Talix, Inc., a premier provider of healthcare risk adjustment and quality solutions for value-based care, today announced its Coding InSight platform and Health Risk Assessment (HRA) application have earned Certified status for information security by the Health Information Trust (HITRUST) Alliance. With the HITRUST CSF Certified Status, these solutions meet key healthcare regulations and requirements for protecting and securing sensitive private healthcare information. HITRUST CSF Certified status indicates that Coding InSight and HRA have met industry-defined requirements and are appropriately managing risk, and places Talix in an elite group of organizations worldwide that have earned this certification. By including federal and state regulations, standards and frameworks, and incorporating a risk-based approach, the HITRUST CSF helps organizations address these challenges through a comprehensive and flexible framework of prescriptive and scalable security controls....
Read More

Upcoming Conference

 

The Risk Adjustment Forum: Operational Integration and Compliance 

This is your can't-miss opportunity to gain proven strategies for enhancing the compliance of your coding and risk adjustment data. You also will get unparalleled insight and tools to help streamline the integration of risk adjustment and quality initiatives, and take away critical lessons learned from plans breaking down operational silos. You will also hear directly from CMS! 

More

Upcoming Webinar

Are You Getting the Most Out of Your In-Home Evaluation Program?

This webinar will focus on getting the most from your in-home evaluations from a clinical and operational standpoint. We will discuss what a good in-home evaluation should contain, how to use this data for care plans and patient stratification as well as analyzing where membership engages to align with a plan’s quality and Star Ratings management.

 

Connect With Us

Copyright © 2014 Resource Initiative & Society for Education. All rights reserved.