Channeling CX Dissatisfaction into Opportunity

Consumers aren’t just selecting their healthcare policies anymore – they’re shopping for them. Studies show that close to 20% of policies sold during open enrollment will be shopped by consumers via private and public exchanges. In the next few years, that number is expected to rise to 50% or higher as more employers move to private exchanges. The key to winning in this hyper-competitive environment is an exceptional customer experience, but today, many payers aren’t delivering one.

Convergys, a world leader in customer experience outsourcing, released the findings of their 2016 CX Metrics & Omnichannel Trends Research, a report based on a survey of 6,400+ consumers taken in June of 2016. The research found that the healthcare insurance provider industry ranks third to last in customer experience, just above cable, satellite, and wireless providers. While this widespread dissatisfaction may sound disheartening, many payers are channeling this reality into new opportunity by focusing on improving the following three centerpieces of the payer customer experience:

1. The Shopping Experience
Every initial interaction with a payer, from placing a call to customer service to engaging in a conversation with a chat bot or clicking an email call-to -action, offers data collection opportunity. The payers that are able to collect and leverage as much customer intelligence as possible in the initial shopping phases can then craft pre-sale communications that feature plans and emphasize benefits that appeal to the unique needs of the customer. With advances in personalized composition software making tailored communications easier than ever before, payers can create templated direct mailers and plan decision guides that allow for dynamic insertion of plan benefits and key messaging based on consumer intelligence data. Website analytics during open enrollment also offer great insights. For example, a page with high traffic or long average session times might be an indicator of high-value content – content that may be serving to educate the consumer on a confusion point that should be integrated into agent training programs.

2. The Claims Experience
While some payers believe that their single greatest competitive strength is their ability to process a medical claim quickly and correctly and at a low cost to the consumer, most consumers consider this a baseline expectation of conducting business with a payer. Convergs’ CX Metrics & Omnichannel Trends Research found that the cost of committing even the slightest error in claims processing is high, and can be a deal breaker for winning the consumer’s continued business next year. For one client, Convergs found that outdated claims processing guidelines drove 280,000 unnecessary calls into customer care, skyrocketing costs and putting future business from every one of these customers at risk. Healthcare leaders must make optimization of claims processing a priority, beginning by mapping the consumer journey and identifying all the pain points against internal processing system to get to the root cause.

2. The Channel Experience
Many payers make broad generalizations of channel preference without taking the time to evaluate what customers actually prefer based on on analysis of behavioral data. For example, one payer optimized their website for self-service bill payment under the assumption that was the preferred payment channel, only to find that many customers prefer automated phone payments, and that there were errors in their IVR system, such as poor menu structure and missing authentication. Payers must take the time to look at current channel usage rate for different activities and let their channel optimization strategy be guided by what consumer behavior tells them. Channel preference often varies from person to person though, as some consumers prefer digital self-service tools for conducting administrative tasks (44%), and others (27%) prefer speaking directly to an agent or call center. For this reason, it is crucial payers are able to understand individual channel preference and let their member interactions be driven by this intelligence.

“Brands need to recognize that they are serving a multigenerational population – in fact, in America alone, there are six distinct generations living today,” said Kathy Juve, ‎Chief Marketing Officer of Convergys. “Our CX research shows planning a strategy based on generational assumptions alone will not lead to success for retailers in today’s competitive environment. From grandparents to preteens, all consumers enjoy using technology and expect technology-enabled solutions when they seek customer service support.”

As expressed by Convergys’ CMO, the most significant takeaway from their research findings is that the continued growth of omnichannel optimization is essential to avoiding customer frustration as a technology-enabled customer experience is important to all generations. In order to support omnichannel optimization initiatives, consumer engagement efforts must move beyond printed direct mail communications and static patient portals to tailored engagement solutions driven by a centralized content repository and a real-time customer intelligence database. To learn how Cierant’s CommONE: Connect suite of personalizedengagement solutions makes omnichannel optimization simple, visit or email to request a demo.

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