Call Center Case Study: Sometimes Time is the Best Medicine

By Eric Camulli

While several variables often factor into the purchase of healthcare coverage, strong customer service can be a true differentiator in the marketplace. Blue Cross of Northeastern Pennsylvania (NEPA) has never been afraid to try new customer service strategies, especially if it creates happier, more loyal customers. For seventy years, the company has been at the forefront of healthcare insurance, finding new and better ways to provide the best choice of coverage, with the largest network of healthcare providers.

In implementing technologies to improve the customer service experience, they have found that incremental improvements can really add up. In fact, for Blue Cross NEPA members, these improvements have added up to more than four years of recovered time.

Raising the Bar:  Bob McDonald, the director of service operations for Blue Cross NEPA, has set a goal to create a customer service environment where everyone has a positive experience. In order to meet this goal, he is using technology to address some of the most common sources of frustration.

One challenge is ensuring that no one has to wait on hold for more than sixty seconds. McDonald also strives to empower members to decide when they want to talk to a customer service agent, rather than dictate to the member when an agent is available. With more than 800,000 calls annually, on three different types of coverage (HMO, PPO, and traditional), meeting these goals has been no small challenge.

“With nearly 600,000 members, our phones are always going to be ringing,” said McDonald. “We can handle the call volumes, but we also want to let our members know that we understand how valuable their time is.”

In 2007 and 2008, a change in claims systems triggered an influx of questions from Blue Cross NEPA members and providers, resulting in a significant increase in call volume. While agents were committed to helping members understand the recent changes, the member experience was not at an acceptable level to meet Blue Cross NEPA’s internal standards.

All three queues were experiencing hold times in excess of acceptable levels for the organization, and some callers were met with a busy signal, which caused frustration among both members and agents. The rate of abandoned calls also increased.

“I wasn’t sure how we could decrease hold time while meeting some of our other goals, such as maintaining a 60-second average speed to answer, with a less than five percent abandon rate,” said McDonald. “During our peaks, we were having trouble staffing; we needed to find a way to even out the call volumes without forcing people to sit on the phone waiting for an agent.”

McDonald discovered the concept of virtual hold. “The idea that we could actually call our members back was exciting to me,” said McDonald. “And, I could see the immediate impact on customer satisfaction, which is ultimately our top goal.”

No, Really, We Will Call You Back: To address its immediate issues related to hold time, McDonald first rolled out call back technology across its three lines of business. “For us, it’s important that our callers have the same experience, no matter which line of the business they contact,” McDonald said.

When hold times are under 120 seconds, callers simply stay on the line and are transferred to a live agent quickly. At peak times, or when hold times go beyond 120 seconds, the caller is given the estimated wait time and offered two options: stay on hold or hang up the phone and receive a call back later, in the same amount of time as if they had waited on hold. Forty-six percent take the callback option. As callers acclimate to the option, usage has increased over time.

For McDonald, allowing members to use their time productively, rather than force them to wait on hold, was an immediate success. Members complimented the company on its use of the new technology, and abandon rates dropped. “Our members trust us to call them back in a timely manner,” he said.

As more callers took advantage of the callback option, average speed of answer improved by 19 percent. This allowed McDonald to better match staffing levels to call volume and offer agents a safety net for unanticipated peaks. The improved call distribution helped increase job productivity and satisfaction. In addition, staff complaints dropped and  work-related stress was reduced.

“We eliminated that first 30 seconds or so of some calls where the caller would sometimes vent about how long it took for us to talk to them,” McDonald said. “It makes calls easier for the agents. Anything I can do to reduce tension between agents and members is a good thing.”

Since the call back is presented as a normal inbound call to the agents, it requires virtually no agent training. “Our agents don’t have to do anything different. We just let them know it was happening,” McDonald said.

Empowering Callers: While he was addressing the hold time issue, McDonald was also implementing new options for customer callbacks. Now Blue Cross NEPA members can schedule a return call for up to seven days in the future, which allows the caller to define when the customer service interaction will take place. On the agent side, the technology works the same, automatically placed at the requested time.

The technology also provides an after-hours service – a feature McDonald is in the process of implementing – allowing callers who try to reach an agent outside of business hours to immediately schedule a callback time during normal business hours. This puts the responsibility on Blue Cross NEPA to make the return call and allows the member to move on with other activities.

While the contact center is meeting its metrics (see sidebar), McDonald is most proud of the impact it has had on Blue Cross NEPA members. “We get comments from members all the time – they’re surprised that we have this capability, and they love the fact that they can go about their business,” McDonald said. “We saved so much time for our callers – in 2008 alone, we reduced member hold time by fifty-six percent.”

Helping Members Stay Healthy: McDonald isn’t done yet. One of the ways Blue Cross NEPA can improve the health of its members while reducing member costs and premiums is for members to keep up with preventive healthcare. To encourage members to schedule check-ups, they manage outbound reminder campaigns.

The company has been testing an application with a recent campaign reminding women over 40 to schedule their annual mammograms. The system is set to contact members and play automated reminder messages upon making a live connection or accessing a voicemail system.

Reminders were sent to more than 2,000 women during the mammogram campaign. Although McDonald is still tracking response rates, early indications show that this is a viable tool for other outbound reminder campaigns, such as flu shots, colon screenings, and PSA tests.

“We want to be a resource for our members,” said McDonald. “And that includes helping people proactively take care of their health, not just answer questions about their insurance.”

As Chief Technology Officer of Virtual Hold Technology, Eric Camulli is responsible for leading the direction and architecture of solution development to ensure that VHT’s virtual queuing solutions meet the needs of a diverse client base. With more than a decade of experience in the telecom and contact center industries, Eric combines technical expertise with an understanding of the challenges facing today’s contact centers.

[From the February/March 2010 issue of AnswerStat magazine]