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Here’s How Customer Service Automation and Healthcare Outsourcing Increase Payer Support During Critical Times


In battling the COVID-19 pandemic, rapid responses to surging customer support volumes are crucial. Health plan members need information and empathy. We’ve identified four member support obstacles where outsourcing and innovative messaging technology offer swift and viable solutions by adding skilled agents and expanding support channels.

1. Long hold times

Especially during a crisis, members need answers. And in many cases, members want to interact with a live person. But voice calls are expensive and an agent can only speak with one person at a time. As a result, bottlenecks quickly form when contact centres are inundated with callers.

How to fix it:
We recommend DIA: deflect, intercept, automate. A chatbot on a website or messaging platform can greet members and collect basic verifying information and in some cases answer questions (deflect and intercept). When the message is transferred to an associate, he or she already has the information needed to assist the member, reducing average time in queue and increasing productivity (with automated support).

2. Licensed agent shortage

Licensed agents are in high demand as questions rise about what is covered under policies and plans for virtual visits, hospital stays, and other COVID-19-related issues. However, mobilising skilled and licensed agents at contact centre locations is nearly impossible when regions are under lockdown.

How to fix it
Healthcare BPO services are a proven way for organisations to quickly expand their workforce. A virtual workforce that is already regulatory and security compliant offers a broader pool of available associates. For example, at TTEC, we apply our recruiting, hiring and training expertise to quickly enable licensed agents to answer questions on eligibility and membership, cover and other enquiries remotely. Additionally, remote workforces can be scaled up or down as needed and increase operational efficiencies while reducing costs associated with a brick-and-mortar location.

3. Sudden volume spikes

In a fast-moving situation such as the COVID-19 pandemic, calls can suddenly spike at a moment’s notice. There comes a point when associates can only answer so many calls at one time.

How to fix it
A work-from-home model with a rapidly deployable workforce helps organisations accommodate for daily fluctuations. Staff can be ramped up or down from a distributed home-based workforce. Also, adding a messaging channel expands the number of customer conversations an associate can concurrently handle. An associate can handle 4 messaging sessions concurrently—4 times the rate of a regular voice channel. During peak periods, for example, callers can be directed to text their questions for faster support, which will also reduce call volumes. During a slowdown, associates can switch back to answering phone calls.

4. Information confusion

Anxiety levels are rising during such uncertain times. Health plans want to make sure that they’re meeting their members’ needs and answering their questions as concerns quickly shift. Health experts are also competing against numerous information sources.

How to fix it:
Proactive outbound messaging is an effective way for organisations to stay ahead of member concerns and reduce call volumes. For instance, once a member has opted into receiving messages, proactively sending a text message with a link to the latest information saves members the trouble of calling the contact centre. The messages can also be modified as the situation changes.

Health insurance firms play a critical role in supporting individuals, especially during a crisis when rapid communication and information access are vital. Experienced partners who are ready to deploy proven solutions such as healthcare outsourcing and customer service automation are more than ready to help.

Learn more about how to build resiliency into your business with secure work from home, automated, messaging and cloud-based solutions on our website.