Our client, a large TPA that manages vision and dental plans for a nationwide insurance company, needed to improve its service experiences. The problem? A patchwork of disparate support systems was holding them back. Faster payments, shorter calls, and better first-call resolutions were within reach if they could unify their platforms. That's where Penrod came in.
Negative support experiences aren’t uncommon in the health insurance industry. According to the Customer Experience Index Rankings, nearly a third of health insurers are now rated as offering “poor” support. Poor ratings have a far-reaching impact, causing members to leave negative reviews, employers to switch coverage, and insurers to face shrinking margins. Member and business problems also trickle down to agents, creating burnout.
The average call center is a hectic picture. Agents switching between screens, trying to piece together information from multiple systems, while a member who is simply trying to understand their benefits waits on the phone. With each passing second, frustration grows. Our client, a large TPA that handles vision and dental plans for a nationwide insurance company, was wrestling with that kind of inefficiency. In an industry where member satisfaction is dwindling, their platforms brought both agent and member experiences to a standstill.
Penrod stepped in to build a connected support experience with Salesforce Service Cloud, Marketing Cloud, and Talkdesk. The result? A system that brings service phone calls, emails, and chats into a single case management queue.
Disconnected support center platforms created member support bottlenecks
Service Cloud, Marketing Cloud, and Talkdesk
Agent efficiency, faster case resolution, better call deflection, and faster payments
Before partnering with Penrod, the TPA's member services team was stuck using six disconnected tools to manage member support. Their primary system for support? A shared email queue that bottlenecked case resolution. When a member reached out, agents often had to "swivel chair" between this queue, phone systems, and member records just to retrieve basic information.
The result? Longer call times, frustrated agents, and a negative experience for members who just wanted answers.
Beyond the call center, the TPA also faced significant hurdles in communicating with members. There was no way to automate outreach at crucial moments in the patient journey, such as sending welcome messages to new members, sending payment reminders, or notifying patients about expiring credit cards. With members not receiving important information about their plans, inbound calls for basic questions skyrocketed.
And the enablement process for new agents? With six systems to train on, it was taking two months or more to get new hires up to speed. That kind of onboarding timeline made it impossible to quickly scale the team up during busy periods, such as open enrollment.
Also, tracking, assigning, managing, and resolving nearly 1,500 emails a day from their online contact form was unsustainable. Without a unified system, their team struggled to keep up with the sheer volume of requests.
Penrod stepped in to build a consolidated customer engagement platform using Salesforce Service Cloud and Marketing Cloud, along with Talkdesk. The core idea was simple. Bring all customer support interactions into a unified system, regardless of how a member reaches out.
For the call center, Penrod implemented Salesforce Service Cloud to give member service agents a single view of every member's interactions and data. The first step was integrating their various communication channels. For phone calls, Penrod used Talkdesk to ensure that when a member called in, agents could quickly verify their identity and view their information. Agents wouldn't have to look up information spread across multiple systems manually.
Email inquiries got an upgrade with the rollout of email-to-case functionality. Now, member emails instantly create cases in Salesforce. They're automatically routed to the right queue and escalated when needed. Agents no longer spend time juggling shared email inboxes or chasing lost requests. Additionally, Penrod ensured that cases from the member portal were integrated into Service Cloud, keeping all member interactions in one place.
Penrod also worked alongside the TPA to build marketing journeys that engaged members at key moments throughout the plan year. Key member journeys include:
With these proactive journeys in place, the call center can predict increases in call volume and staff accordingly. Routine inquiries dropped, and members felt supported from the first day of their plan.
Penrod also integrated the TPA's knowledge base and document management system into Salesforce, making all member information readily available to agents from a single system. Salesforce now serves as the central hub for all member engagement.
The TPA saw significant improvements across its operations with a centralized platform. One of the biggest wins? A boost to agent satisfaction. They no longer struggle with multiple systems to look up patient information, find answers, or complete cases.
Efficiency meant agents could focus more on helping members and less on swivel-chairing between multiple systems.
The call center also experienced:
Looking ahead, marketing journeys will drive: