Customer Care: Helping Insurers Weather Healthcare Reform

By Jeff Hechemy, group president, Healthcare Payer and Pharmaceutical Services, Xerox

Have you picked up the phone lately to get information about your health insurance coverage? Chances are your inquiry was handled by one of approximately 9,000 Xerox call-center employees dedicated to health insurance. While Xerox’s large customer care capabilities are news to some, our ability to staff and train employees in this area considerably contributed to Xerox’s recent designation as one of the best business process outsourcing providers for health insurers.

The recognition came from analyst firm HfS Research, which ranked BPO service providers in both innovation and execution to determine which were best positioned to help insurers comply with the Affordable Care Act (ACA). The push for affordable health insurance will require that payers contain both administrative and medical costs by improving products, processes and customer engagement. This challenge intensifies, when you consider that health insurance exchanges will go live Oct. 1, bringing an influx of new calls and individual health plans to service. That’s where Xerox comes in.

We work with the top 20 U.S. commercial health plans, touching nearly two-thirds of the nation’s insured population and processing more than 900 million healthcare claims every year. How does Xerox achieve this? Well, in addition to supplying the staff necessary to handle administrative services for our clients, we are always looking to simplify business through innovation.

Take, for example, the call-center platform we developed using behavioral research. After analyzing the way customer care agents handled calls, found answers and processed requests, we came up with a user interface similar to that of tablets and smartphones. The computer screen enables our customer care agents to perform all of their call-center functions from one screen, rather than having to access multiple software platforms to complete tasks such as tracking claims, routing calls and distributing documents to customers. In addition to reducing call times by 20 percent, the platform can cut training time for agents in half – freeing time to handle more inquiries.

Faster turnaround times can mean the difference between satisfied customers and lost business. With the ACA requiring millions of Americans to purchase health insurance, payers who are doubting their capacity to handle higher call volumes and plans should move quickly to identify a third-party administrator with proven experience.