Healthcare insurers play a key role in the wellbeing of millions of people. For those of us lucky enough to have insurance, they’re there – on hand and ready to take action in a flash in our greatest moments of need – at least we hope they are. Not every call to our healthcare insurers is an urgent one however – we might just want to call to find out if we’re covered for a medical procedure or to ask a housekeeping question about our policy. Whatever our reason for contacting our healthcare insurers, we expect at the very least a rapid response followed by a helpful, supportive and kind interaction. The business is that of care, after all.
The majority of interactions between healthcare insurers and their members take place over the phone, so it’s unsurprising to learn that picking up the phone to talk to an advisor places an enormous pressure on insurers’ customer care resources. The upshot of a lack of resources is not good news. Valued members are left hanging on the phone waiting for an agent to be freed up, regardless of the urgency of their enquiry. Every minute of waiting and every tinny loop of Bach’s fifth symphony adds a new level of annoyance to the proceeding – so by the time they’re through to an actual person, there’s a wall of frustration that requires time to gently dismantle. Add to that a little ping pong to and fro between customer service agents to find the right person to answer the question and there’s the very real danger of an exploding customer. Even if a great agent is able to defuse the situation, after a long wait conversations inevitably begin on a defensive. This can be tense and stressful for all parties, neither of whom have any control over the situation at hand.
“The double insult is that the process is frustrating for members and
is ALSO very expensive for the insurer.”
The double insult is that the process is frustrating for members and is ALSO very expensive for the insurer. A single phone call can range from a few dollars to $30 or more for longer, more complex calls. And with the very high volumes of calls that healthcare insurers receive, the costs become very significant indeed. The status quo does not serve the member’s needs particularly well, or give healthcare insurers an efficient way to handle large volumes of interactions.
So why is customer service in healthcare failing in this way? Insurers have been experimenting for years with new digital channels to engage their members, they’ve made their websites much richer in content and information, and touted mobile apps that encourage their members to self-serve. Their initiatives have had positive impacts for the most part, but the volume of phone calls remains stubbornly high. The Covid-19 pandemic has greatly exacerbated pressures on insurers’ contact centres and as a result we have seen a significant decline in service levels and customer happiness.
A relatively recent digital initiative has seen insurers launching chatbots to handle some of their members’ simpler requests, queries along the lines of “when does my policy need renewing?”. The majority of these chatbots are text-only and function in the manner of an automated webchat with quick responses to simple questions, so they can only perform a basic service. There have also been attempts to enhance voice-based automation via Interactive Voice Response (IVR) systems. These can be used to help route callers to the correct department to avoid unnecessary waiting times. This may have helped avoid the ping-pong effect between agents, but, as an oft-cited New York University study showed, people are not very positive about IVR systems – an unconvinced 83% suggesting that the IVR system offered no benefit. A more recent study by Vonage found only 13% of callers found an IVR made for a good experience.
“What can insurers do to improve experiences and build scalable operating models that deliver excellent customer care?”
Despite current frustrations, members’ preferred form of communication is the telephone. So, rather than forcing a change of channel, insurers need to find new telephone-friendly solutions.
Fortunately for them, there is an emerging new paradigm in customer service that provides a new kind of automation over the phone – and it’s available to members 24/7. This new flavour of conversationally-led AI is all about making interactions with automated customer service agents both easy and enjoyable. It provides a level of service we refer to as a ‘delightful’ experience.
The core driver of this new approach to automation is being able to understand customers each and every time they open their mouths to speak. Being understood first time allows customers to enjoy new levels of service in both relevance and responsiveness. action.ai’s advances in computational linguistics and pioneering work on machine learning mean it is now finally possible to deliver this kind of automation at scale.
“Everybody benefits from delightful automation, every time.“
The result of quality automation is that customers get the service they want, when they want it, at their leisure night or day. Insurers benefit too. They are armed with the superpower of being able to handle thousands of calls at once and greatly reduce the burden on their besieged contact centres. No automated assistant ever has an off-day and these virtual agents are equipped with the ability to empathise with members, who rightly expect to be both cared for and valued. Everybody benefits, every time and all the time.
This is a key moment for healthcare insurers facing huge pressures on their contact centres; they now have a route forward that will exceed members’ expectations within a process that is both monumentally efficient, but importantly, scalable. action.ai is working to ensure that calling your healthcare insurer can be good for your health, and also good for the health of your insurer.
