Navigating the healthcare system can be challenging and intimidating for individuals and changes that are currently taking place can make it even more confounding. In order to help customers navigate the complicated landscape, health insurance providers need to act as advisors and organize themselves around members' needs, stresses Austin Waldron, senior vice president and chief customer service officer of Health Care Service Corporation, which runs Blue Cross and Blue Shield plans in Illinois, Montana, New Mexico, Oklahoma, and Texas.
Especially since the Affordable Care Act requires standardized plans, service delivery will act as the differentiator that help customers choose a provider over a competitor, Waldron notes. "This takes away difference in benefits. If the benefits are identical, the ability to provide better customers service and advocacy is more important than ever," he says.
And many times, when it comes to healthcare, members want someone to talk to who can explain their benefits and help them find the care that is most appropriate for them. For this reason, HCSC established a contact center specifically to answer questions about the Affordable Care not just by its own members, but any individual who has a query, Waldron explains. The organization is receiving an average of 1,500 calls daily, underlining the need for a health insurance provider to take the time to answer questions.
One service need that members are requesting from their health insurance provider is upfront information and counsel. "We need to take the confusion away," Waldron notes. Often, members feel torn between what their doctor is telling them and what is covered by insurance and it's imperative to clear the confusion upfront rather than when a member has already sought expensive treatment.
In order to make sure that its customers' service needs are being addressed, HCSC encourages members who call into its contact center to take a survey. Waldron notes that if at any point the member indicates a problem with the way the interaction was handled, a supervisor will immediately take the call to get more specific feedback on the customer's dissatisfaction.
The next step in HCSC's journey to deliver better customer service to its members is to identify different personality types and direct them to agents who are most apt to deal with that particular personality. Waldron notes that HCSC is in the initial stages of this project.