During open enrollment period for health insurance, Security Health Plan faced the challenge of meeting high customer service call volumes, managing a heavier load of data, and managing platforms their customer service agents (CSAs) use.
Security Health Plan offers health insurance plans for families, individuals, and employer groups. They also work with individuals over 65 to provide Medicare plans and with Wisconsin families that need BadgerCare plans.
Because Security Health Plan didn’t have a streamlined customer service platform, CSAs used multiple platforms during customer service calls. They constantly hopped back and forth between screens to find the documentation they needed, input new customer demographic information, and find plan benefits.
The Problem
Multiple Screens and Platforms
During a customer service call, CSAs had to juggle up to 10 screens and platforms. The time they spent switching between platforms made for long customer service call times, longer hold times for new callers, and fewer customers helped.
Scattered Documentation
During a call, CSAs need specific information to use when speaking with members, to ensure they provide consistent, accurate and complete information. They also need documentation to provide the customer with the best and most streamlined experience possible. Security Health Plan’s required information and documentation was scattered throughout the organization’s network, resulting in longer training times for new CSAs and longer call handle times overall.
Difficult-To-Update Customer Demographics
Security Health Plan also lacked a process to update and approve member demographic information. When a member called to update demographic information such as a name or a new address change, making these changes was extremely difficult and time-consuming for CSAs, again resulting in longer call handle times and lower member satisfaction.
Long Training Times
Security Health Plan also needed temporary customer service staff during open enrollment season to handle a substantial increase in call volume. New employees had to learn how to juggle multiple platforms, search for scattered documentation, and find the right verbiage to use with members, so training could take one to two months. In some cases, by the time new CSAs were trained, the additional staff was no longer necessary because open enrollment was almost over.
Training large numbers of temporary staff for one to two months to field calls only during open enrollment costs valuable time and employee resources for each temporary staff member. This long training time and high cost cut into bottom lines and made it difficult to bring on CSAs.
Before Service Cloud
-Average talk time: 7:45 minutes
-Average call wrap-up: 6:43 minutes
-Average total call handle: 14:28 minutes
-Number of platforms: 10
-Weeks to train: 4 to 6
After Service Cloud
-Average talk time: 6:50 minutes
-Average call wrap-up: 5:21 minutes
-Average total call handle: 12:12 minutes
-Number of platforms: 1
-Weeks to train: 2 to 4
The Solution
To solve the headaches Security Health Plan faced, especially during open enrollment season, Penrod used Salesforce Service Cloud to create a customized solution to manage customer data and demographics, call information, and documentation.
One Streamlined Platform
Penrod built Salesforce Service Cloud to include all the data CSAs need during a call on one platform. An easy-to-use dashboard helps CSAs monitor the call and quickly navigate to data they use for each call.
Simple to Find Knowledge
Instead of searching in multiple locations for the correct information and documentation to use, CSAs can find all the knowledge they need in the Knowledge Base section of their platform. The information is easily accessible during customer service calls, helping CSAs shorten call handle time.
Customer Profiles
Plan, benefits, and demographic information for each member is stored on a member profile. CSAs can navigate to this page to view all relevant information. Instead of struggling to update customer demographic information, simple demographic changes are now automated. CSAs simply click update on the member page and can edit the demographic information on the member page. From there, a case is created and routed to the appropriate team to finalize those changes.
Automation
Instead of multiple team members working on a case, each member has one point of contact. This is possible with automation so that every change is sent back to the original person working the case even if it has to be routed to a different person or team during the customer lifecycle. CSAs can track their cases and see which cases are in the hands of a different team to track progress and ensure they are routed back to themselves.
Storage
Since healthcare data is sensitive, Security Health Plan needs information stored on their own servers. Penrod integrates Salesforce Connect to ensure sensitive information isn’t stored directly in Salesforce but in Security Health Plan’s own network. Information lives in and is pulled from a centralized data warehouse.
Other Custom Features
In addition to all of the above, Penrod also offers custom development features to meet specific business use cases. For instance, we built member search pages to simplify finding a member’s profile. We created relationships in Salesforce between members and callers. These relationships shorten time identifying the caller, their authorization to receive information about the member and ability to speak on behalf of the member. These relationships also help track information for auditing purposes. Additionally, all member information can be listed on one page so fewer clicks are needed to find information. When a CSA is on a call with a member, notes from previous calls immediately pop up so the CSA has all the relevant information needed to help the member.
What’s included
-Machine learning and artificial intelligence
-Custom development of features to meet specific business needs
-Knowledge base for all legal information, documentation, and standardized answers
-Unique profile for each member
The value
-Fewer clicks to find relevant information for each call
-All necessary knowledge in one place to shorten call handle times
-CSAs have access to all relevant member information to provide a consistent customer journey
-Shorter CSA training periods
The Results
Faster Case Resolution
With a streamlined software system to help CSAs manage calls, most cases are resolved on the first call. For calls that need to be escalated, automation and native Salesforce functionality shortens time to resolution as well as tracking those calls to help the organization better assist customers in the future.
Shorter CSA Training Periods
When CSAs only need one platform to manage a member’s call, quickly find all the documentation they need to respond to a member’s inquiries, and easily update member information, CSA training periods become much shorter. In some cases, the streamlined workflow reduces training periods from around 4 to 6 weeks to between 2 and 4 weeks.
This shorter training period enables health plans to be nimble during open enrollment and able to quickly bring on temporary staff to meet high call volumes.
Shorter Call Handle Times
CSAs are able to quickly and thoroughly respond to member inquiries with Salesforce Knowledge. All standardized responses, documentation, and plan information is at their fingertips during member calls, which helps them resolve calls faster. For Security Health Plan, call handle time was cut by more than two minutes, and average call talk time was cut by one minute.
Streamlined Member Experience
Member profiles in Salesforce keep the entire team up to date on the most recent member information. Notes and demographic changes are made in real time and are easily accessible during a member call so that each CSA is able to provide the member with the best service possible.
Ready to deliver better patient experiences? Talk to a Penrod representative today.