Client Successes |
Contact Center Optimization Dramatically Improves Call Accuracy and EfficiencyMidwestern Blue Cross Blue Shield Organization A midwestern Blue Cross Blue Shield (BCBS) is the state's leading customer-orientated health benefit services company. The company arranged for the payment of more than $4 billion in annual claims payments to health care providers and members and helped 1.6 million members to receive care. The organization's customer service representatives (CSRs) are located in multiple service centers that handle over 1 million inquiries a year from members and providers. In dealing with these calls, BCBS must comply with strict Service Level Agreements that use contract-specific and Blue Cross and Blue Shield Association's service performance monitoring program - Member Touchpoints Measures (MTMs) - to assess the company's performance in terms of the inbound customer service phone calls. ChallengeAgainst this background of compliance, CSC's call accuracy and efficiency performance goals were not being achieved; and future performance targets looked difficult to attain. The problem was compounded by the fact that CSC had evolved organically. The CSRs were in small business units that served only one product group. Over the years, each business unit had applied business processes as it saw fit. There was no uniform approach to answering calls that guaranteed promptness, accuracy, courtesy, or that matched various types of inquiries to the CSR with the right set of skills. Finally, among other problems, the current metrics were not driving the right actions for a quality customer experience or efficient operation. As a result, members encountered CSRs with limited product knowledge, which prevented first call resolution. Instead, CSRs transferred calls if information was not quickly available or take ownership of a particularly difficult call because it might affect their AHT or call accuracy ratings. Approach and ResultsThis BCBS realized that they would have to undertake some significant changes and called upon CVP's healthcare-specific CRM expertise for assistance. CVP's CRM optimization approach quickly uncovered the core issues that needed to be addressed. After reviewing the goals of the customer service center, CVP examined opportunities related to customer experience and interactions, organizational design, call routing process workflows, quality assurance and management, performance measures and continuous performance improvement processes, workforce management techniques, and the use of technology to determine how the current status compared to the desired outcomes. This allowed a business case to be documented and for the necessary CRM Roadmap to be developed. The collaborative CVP-BCBS team identified several high leverage areas of improvement of which the expected results include:
CVP is currently engaged in assisting BCBS execute the roadmap that focuses on redesigning and aligning the call routing process, quality assurance process, and performance measurement and management process around better serving their members. |
