healthcare customer experience, healthcare insurance Customer Story BPA Quality case study

US National Healthcare Provider 

The lack of a centralized, independent quality process across multiple Contact Center vendors was leading to a lack of consistency and negative healthcare customer experience outcomes.

The challenge
Solution
Outcomes
On-going evolution

Our client needed to centralize a quality process that was stretched across different contact center vendors, individual state programs and procedures.

Contact center vendors would report on their own accuracy, but little confidence existed in the outcomes.

The lack of consistent standards prevented results being compared fairly across organizations.

Agents used false efficiencies such as hot key comments, no notes, lack of detail and general information error when documenting cases leading to repeat calls, increased handle time and negatively impacting CX.

BPA Quality was taken on to undertake independent quality monitoring on behalf of the Client.

A three phased approach was developed to support the delivery of consistent standards and process improvement.

Phase 1: Build Competencies and foundation

The focus for this phase was to provide our evaluators with the knowledge to become experts in our Clients’ business. With the complexities of health insurance, training is lengthy and required extensive audits and calibrations.

Phase 2: Strategic Account Management

Building a strong relationship is critical to our Clients’ success.  We conduct regular conversations about all aspects of the operations, ensuring the Client is fully informed and satisfied with production and quality.

Phase 3: Growth and Sustained Partnership

Success is gauged by the growth of engagement with our Client.  Through strong partnership, we have guided our Client into new areas and continue to focus on greater business intelligence.

Over 120,000 interactions evaluated annually.

Over 20 targeted quality insight reviews delivered to the Client in the 1st year.

Developed behavioral-based metrics to align quality results with CSAT and NPS scores.

Leadership notifications in place to spotlight immediate service recovery opportunities.

Targeted evaluation process developed to ensure Client compliance with state and federal regulations.

Numerous recommendations submitted to update and improve Client process documentation resulting in associate improvement and gained efficiencies.

Implemented a prospective evaluation process for new lines of business focused on member point of view and needs.

Proactive Business Intelligence analysis provided resulting in cost savings, positive customer experience and increased value.

This is a long-established relationship with a focus on continuously enhancing CX, employee engagement and business results.

Future direction opportunities identified for this Client include:

 

    • Increase foreign language support
    • Targeted evaluation samples to focus on key business initiatives
    • Expanding into more focused and targeted evaluations