Enhancing The Healthcare Experience- Smoke Cl

Executive summary

Our client, a leading health and wellness company and one of the largest not-for-profit health insurers in the USA, offers insurance plans, primary and specialty care, and wellness solutions to over three million people since the 1930s.

After 80 years, their mission remains creating healthier futures for customers and communities. The client prioritizes quality, affordable healthcare for all, collaborating with providers for sustainable solutions. Partners and healthcare

providers play a pivotal role in providing outstanding customer service.

To enhance service, our client sought feedback to identify internal improvements within certain service departments. They turned to Smoke Customer Intelligence for an easy deployment within their Genesys Cloud environment.

Through the partnership, over 980 agents were onboarded, and inbound and outbound IVR surveys were implemented. Real-time feedback informed strategy, enabling improvements within targeted departments.

The Challenge

3 million customers are serviced through multiple departments, each with their own contact centre, which receives inbound calls and makes outgoing calls. The client aims to provide superior customer experiences across all touchpoints and, as such, sought to identify areas of operational and service improvement within certain departments within the company. Moreover, they work together with providers and partners to pro- vide customer experience, and thus wanted to understand how to improve operations for partners/providers within these departments.

Traditionally, the organisation struggled to gather meaningful feedback due to a practice that relied mostly on email surveys, resulting in low response rates. They, therefore, needed a feedback solution that would provide real-time feedback and sufficient data on which to base decisions.

Also, since their organisation used Genesys Cloud as their contact centre platform, they sought a provider that could deliver on their business requirements and that was firmly integrated into Genesys Cloud. With Smoke Customer Intelligence being a premium Genesys AppFoundry solution and offering both the functionality and professional services to suit their business requirements, they found the partner and solution they needed to meet their requirements.

The solution

“The secret to patient care, is in caring for the patient” – Dr Francis W. Peabody.

Six departments within the organisation, focusing on members, providers, care management, broker services, hub escalations, and pharmacies, participated in the project. Over 980 agents were onboarded onto SmokeCI’s proprietary survey platform,  Eyerys,  which  easily integrates into Genesys Cloud (and other telephony platforms), and inbound and outbound post call voice surveys (Interactive Voice Response – IVR) were implemented.

The IVR survey questions were customised and tailored to suit the requirements of each department – collecting relevant information to identify areas of operational and experiential improvement for both customers as well as providers and partners. Surveys measured metrics such as Customer Satisfaction (CSAT), Agent CSAT, Ease, Net Promoter Score (NPS) and ITR (Intention to return).

Eyerys’s real-time, automated escalations ensured that relevant team members received any negative feedback immediately, allowing them to follow-up with the customer, provider, or partner to improve overall service recovery. Furthermore, data received from the feedback enabled the organisation to identify areas of improvement and implement measures to better overall service delivery and customer experience.

“It’s very important to have a feedback loop, where you’re constantly thinking about what you’ve done and how you could be doing it better.” – Elon Musk

A dose of CX

Working closely with our client, SmokeCI implemented an IVR solution for enhanced feedback, enabling moments of delight for customers, partners, and providers.

Nearly 1000 agents smoothly joined the Eyerys system, seamlessly integrating with the client’s Genesys Cloud contact centres.

Customised post-call surveys from both inbound and outbound calls provided valuable insights into departmental operations and service levels. Automated escalations ensured swift responses to any negative feedback.

In addition to enhancing the overall experience, operational improvements were made within six departments: members, providers, care management, broker services, hub escalations, and pharmacies. This led to cost savings, streamlined processes, and optimized functions and platforms.

The organisation showed an increase in post call survey responses following the implementation of SmokeCI’s VoC solution, supplying the client with insightful data that identified risk areas, potentials for cost saving, and which informed the overall customer, partner, and provider strategies.

Thanks to the success of the solution and the partnership, the client was able to meet their objectives. They are committed to continuous improvement and plan to expand the project to other departments and implement surveys through different channels and touchpoints in the near future, together with SmokeCI.