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Embrace the future of CX

Payers reflect on an award-winning open enrollment season

“Everything Everywhere All At Once.” The title of the Oscar-winning film pretty much captures what annual open enrollment is all about in the world of healthcare: a flurry of activity in the contact center as associates sign up millions of consumers for new health plans.

It can be intense, with drama. And just like the film industry, how things go at the Awards ceremony depends on how well everything played out the 12 months prior. Companies with a proactive strategy for enrolling members to Medicare, Medicare Advantage, individual and family health plans are the ones that delivered the best customer experience while exceeding KPIs.

Three clients of TTEC shared rave reviews of their most recent open enrollment period.

With feedback like, “Words can’t accurately convey the ‘wow’ moment upon seeing RealPlay bots in action....” or “We just haven’t seen technology like this…,” you know AI and other advanced solutions worked exceptionally well during open enrollment. Not flashy, just a good fit for the circumstances.

When payers go on to say conversions rose, average handle time (AHT) fell, and cost savings met or exceeded expectations, it’s clear the process was efficient and productive. When the CMS secret shopper program awards 5-star ratings and customer satisfaction scores rise, well, it doesn’t get much better than that.

Encore for 2024?
That’s what payers are thinking right now as they ramp up for the next enrollment season. Each TTEC client had unique challenges as they geared up for 2023 open enrollment. And each reported award-winning results:

Doubled conversion: A new client facing its first open enrollment period as a TTEC partner knew its manual processes were costly, inefficient, and inconsistent. TTEC brought in its RealPlay Bot to accelerate learning for the all-important Medicare annual enrollment period and exceeded goals.

“We would consider a first AEP successful if we could meet our goals, have minimal but expected hiccups along the way, communicate well, and performance is optimal,” the client wrote, adding a smiley emoji. Goals were exceeded even before enrollment was finished, including:

  • $501K cost savings
  • 10% reduction in AHT
  • 100% conversion rate increase in 2 weeks’ time 

Speedy ramp-up, 5 Star rating: A regional health insurer was suddenly without a vendor partner as open enrollment and Medicare annual enrollment approached. The company brought in TTEC to quickly assess the current state of technology and processes.

TTEC onboarded their client to a new customer relationship management (CRM) system, new telephony platform, and Lighthouse knowledge management system. TTEC also improved the integrated voice response (IVR) system to let members renew their plans via self-service.

Associates enrolling members were far more productive and efficient thanks to TTEC’s Associate Assist virtual assistant that "listens" to call interactions. Based on what’s asked, it displays appropriate responses on screen—in the same moment a question is asked. Results:

  • 20% conversion rate above goal
  • 5 Star secret shopper ranking from CMS
  • 10% shorter AHT than target time
  • 100% Google rating boosted from 2 stars to 4 stars 

Top quality scores: Another client sought a partner to help revamp its hiring and training for Medicare Advantage enrollment. TTEC helped the insurer acquire the right skill sets and deployed training bots to get new hires up to speed quickly.

The bots role-play with associates so they can practice handling calls in a mock scenario before taking live calls. With optimized call flows and workflows, everything was looking up:

  • 9% sales surge
  • 7.3% conversion rate increase
  • 97+ quality scores 

Different clients, different challenges but a common vision
Each payer faced its own set of unique challenges and resource allocation varied from company to company. Some clients are rather large while others are small but growing. They shared was a commitment to a well-defined strategy, acknowledgement of gaps, and genuine desire to improve processes rather than cling to legacy thinking.

For some, artificial intelligence was a known but untried concept. Using bots for training of contact center associates may have felt like a risky idea at first. Seeing the AI-powered bots in action put any lingering concerns to rest.

“Words can’t accurately convey the ‘wow’ moment upon seeing RealPlay bots in action,” said a client’s senior manager in Medicare telesales. “I was blown away by the bot speaking back. I even asked if what I was seeing and hearing was real because it was so amazing.”

Clients were equally impressed with TTEC’s new “objection” bot. This new bot assesses the top reasons prospects fail to convert. It then uses that information to role-play with associates in simulated customer interactions. Associates who practiced their new skills in a virtual setting performed better taking live calls than those who didn’t.

AI-powered bots are also integral to TTEC’s Stevie Award-winning sales effectiveness certification program. It pulls together people, processes, and technology to coach sales associates in real-time, drive performance, and speed proficiency.

One of the most compelling common elements clients shared was access to TTEC’s Centers for Excellence, an epicenter of proven, repeatable strategies and solutions deployed by TTEC’s best-performing clients. The center is home to top call drivers and solutions any organization can leverage to achieve their goals and objectives.

Annual enrollment should be an exercise in continuous improvement, and TTEC’s Centers for Excellence keep evolving to focus on the top drivers of ROI and customer satisfaction.