What companies define by customer service is changing every few years. And the contact center is one area that transformation has influenced heavily. For this reason, a brand is now defined by the level of customer satisfaction it holds. Especially in the healthcare insurance sector post pandemic, the communication customers have with the healthcare payer directly translates to customer lifetime value. A look at the chart below will tell you how contact centers have been digitally transforming and the key focus areas on the Customer Experience Management for the contact center.
Uniphore recently conducted a survey that gave out pretty interesting results.
Even though these stats show that health helplines need to take action to improve their customer experience, not many organizations are ready to take the digital transformation plunge. This cycle makes your technical debt increase further and hence your automation debt. The survey also showed that 76% of those surveyed preferred to human assistance or in contact center terms “to speak to a live agent”.
Digital transformation using Intelligent automation is an orchestrated approach that uses Artificial Intelligence (AI), Robotic Process Automation (RPA), Natural Language Processing (NLP) and sentiment analysis to enable callers for self-service. This integration has enabled organizations to deliver superior customer service by creating an ideal balance between humans and machines. RPA interacts with medical records in the back end to fetch and analyze data hence reducing call times of the customer and also saving time for the agents to do more meaningful work. All this results in reduced operational costs with performance that has improved manifold.
The pandemic has put a pressure on healthcare payers in an unprecedented way. Although the tug-of-war between hospitals and payers is nothing new, a recent news article from KHN talked about how 100's of Millions of USDs exist in unpaid claims due in part to a new claims management system and claims processing changes. And this is just one of the challenges healthcare payers are facing today. Piled up with unprocessed claims are a heap of claim denials from leading payers. Directly affected by a claim delay or denial are disgruntled patients and plummeting customer experience.
The need for automation for healthcare payers is now more evident than ever. A breakdown of the process flow of the claims processes will show you the scope for up to 80% of automation. RPA can be leveraged to automate claims prior authorization increasing the overall speed of the claims processes.
Let us look at a Medicare enrollment use case where RPA powered by Artificial intelligence takes over the contact center to provide enhanced, human-like experience to the caller.
Lateetud has used Intelligent Automation to help large healthcare payers streamline their businesses and manage their claims traffic better. While there is a large group of payers still contemplating adopting automation, IA powered contact centers will continue to influence the growth of customer experience management for healthcare payers.