The Affordable Care Act: Top 5 Contact Center Initiatives Not to Be Ignored

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The Affordable Care Act: Top 5 Contact Center Initiatives Not to Be Ignored

A Thought Leadership Advertorial from Interactive Intelligence (News - Alert

The Affordable Care Act has already brought millions of new customers to the healthcare market. And under the new law’s guidelines, it looks to bring millions more — making the consumer environment for healthcare and insurance more competitive than it’s ever been.

For many insurance and healthcare companies, it’s new territory. They must differentiate themselves to attract the ACA’s new enrollees, and providing a superior customer experience to these potential new members and patients is one of the best differentiators. But, new territory again. Customer service processes in many insurance and healthcare organizations have long been considered inferior, and with largely unforgiving budgets, improving service remains a low priority.  Even for ACA purposes.

Nevertheless, the Affordable Care Act is as much an opportunity for insurance and healthcare providers as it is for consumers requiring their services. Implementing five straightforward initiatives in the contact center can help providers capitalize. 

Innovation. With the new wave of unified technologies and cloud solutions, insurance and healthcare organizations bridge gaps between the contact center and enterprise business units. More importantly, they bridge gaps in communication, collaboration, business processes, and data flows, equipping them to handle greater volumes of member, patient, and provider inquiries and issues more efficiently. In the contact center, easily integrated telephony features like skills-based routing and screen pops to member files improve the service process. Interactions are routed faster and more intelligently, and agents instantly know the member, provider, or other party in complete detail. With service that’s more personalized and first contact resolution rates at consistently higher levels, providers improve customer/patient satisfaction.

Multichannel. Healthcare and insurance customers expect to be able to choose the communication channel that’s most convenient and available to them at a given time and location. Providers must therefore look to a solution that satisfies that requirement, offering channels for email, chat, web, SMS texting, inbound voice, self-service IVR, outbound outreach, and social media. Beyond offering these different channels, it’s imperative to manage them efficiently, and to ensure full integration and reporting.

Analytics. Pulling administration system data, line of business data, CRM information, and other data types — aka Big Data and its resulting analytics — lets providers gain invaluable insight into their customers and business. Interaction analytics should be on the same level. Details of how, when, and why interactions take place can prove beneficial in pinpointing customer issues, and can enable providers to create more intelligent ways to handle incoming and outgoing interactions.

Training. The ACA’s changes in regulations, procedures, and associated technology necessitate continuing education and reevaluations of curriculum and content on a regular schedule.

Content and knowledge management tools are great resources for training, as is the current trend of “just-in-time” learning via the web, smart phones, or even YouTube (News - Alert) videos. As a best practice for agent training within the ACA program, quality assurance processes should include a review of agent inquiries to ensure that agents are adhering to proper ACA processes and procedures.

The customer experience. Multichannel options, informed contact center agents, and making timely information readily available to members can help insurance and healthcare providers build their customer base. So do things like self-service channels for claims status, chat assistance for enrollment, and mobile apps for provider and network information. But a key provision of the ACA dictates that healthcare institutions can get reduced reimbursement if there’s a short timeframe for readmission for the same ailment. One way to address this mandate is with ongoing patient engagement — even after a patient has left a healthcare facility.

Remaining in contact with patients through outbound communication automation for appointment reminders, post-care check-ins, and other follow-up can help patients keep appointments and cut readmissions costs at the same time. The contact center is best suited to handle these services by providing automation, consistency, and an easy opt-out to a customer service agent if needed.

All told, five achievable initiatives in the contact center hold the potential to improve member and patient satisfaction immensely. In the new age of the ACA and market competition, these initiatives can also improve how consumers view your insurance or healthcare organization.

For more information on the customer experience solutions from Interactive Intelligence, visit us at

Edited by Stefania Viscusi
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