By Kevin Walsh, senior vice president and managing director, Eligibility and Insurance Exchange Services, Government Healthcare Solutions, Xerox.
Customer care centers will play a critical role in the overall success of a state’s health insurance exchange. A customer care representative may be the first person with whom someone talks about how her state’s health insurance exchange works, what her options for insurance are, and how to enroll. Through personal contact with these front-line representatives, Americans can receive reliable, accurate information to make important healthcare decisions.
With an estimated 7 million Americans planning to enroll in insurance through the exchanges, the need for robust, well-equipped customer care centers is essential. Selecting and buying health insurance through an exchange will be a new experience for many Americans. Millions will have questions about both the process and the options available to them. Most consumers won’t be able to start evaluating health insurance options before October 1 as exchanges make last-minute preparations, like evaluating health plans and loading them into their systems. Customer care centers need to be ready to field the impending influx of calls from citizens looking for more information.
The massive influx of calls isn’t the only challenge facing states. Capacity planning, the knowledge-base of the agents, wait times for calls to be answered, and the ease with which a representative can connect a caller with the appropriate government agency to help move an application forward are other likely challenges they also will confront.
Reliable vendors are available to help states mitigate these risks. Identifying a dependable partner with both healthcare and customer care expertise is key to help refine the operation, speed up application processing and keep citizens informed. Many states may also turn to partners who have the ability to train specialized staff and the flexibility to scale staff up and down quickly to meet fluctuating demand.
Xerox is helping several states with their customer care centers. In New Mexico Xerox is operating a customer care center that will answer calls about the state’s health insurance exchange, known as NMHIX.
Most states have customer care centers available, but levels of technical and professional expertise will vary from one state to another. Is your state’s call center up to the challenge?