Updated: Mar 20
Innovation is simplifying call center recruiting, training and scaling. Technology enables call centers to “ditch the scripts” with a conversational approach where members do most of the talking. Rather than hearing a scripted health plan or ACO introduction, the member talks about who they are, including the people and events that matter most to them. The goal is to get to know each member, making them feel heard and appreciated.
Technology acts as an all-knowing virtual assistant that guides this conversational approach. Cognizant of the engagement campaign’s emphasis, plan/ACO details and compliance requirements, call center agents are guided through discussions ensuring that all goals are met.
Interacting with the conversation, the virtual assistant advises the agent on how the health plan or ACO matches the member’s unique lifestyle and aspirations. Provider networks are introduced based on how they personally support the member as if the plan was created with them in mind. For example,
“Our provider network is fully integrated. Data and results are shared between all providers and locations. Better communication eliminates redundant paperwork and screenings. Our goal is to provide better outcomes with fewer visits compared with out-of-network providers who don’t communicate with each other. This is the perfect fit for your super-busy lifestyle.”
By letting members do the talking, they clarify their needs. Interactive technology advises the agent by listing the plan benefits that best support the member’s unique lifestyle and aspirations.
“You take three buses to get to your Dr. and that doesn’t work when you’re sick. Your plan offers a no-charge medical transportation benefit. A warm ride each way and no more waiting in the rain. Let’s talk about this.”
“It’s so exciting to hear about your upcoming trip to see your daughter in Cleveland. Did you know that your health plan is accepted by Drs. and hospitals nationwide? You can travel in confidence, knowing that we’ve got you covered.”
Conversational engagements are a pleasant surprise for members, unlike anything they’ve experienced from a health plan.
Staffing and scaling the call center is greatly simplified as technology acts as a real-time subject matter expert whose job is to support the agent. Informed by the conversation, the virtual assistant recognizes issues related to churn risk and advises the agent to discuss and defuse potential problems. Agents are alerted and guided when potential SDOH issues are identified. Instead of a yes/no report of social isolation, members discuss context as well as solutions that would make them happy. The virtual assistant recommends zip-code-specific local support services as well as appropriate supplemental benefits. Introductions, benefit literacy, SDOH/HRA risk assessment and member loyalty are expertly addressed by the same call center agents who used to read scripts.
Finally, recruiting is greatly simplified as technology provides needed expertise related to network introduction, plan benefits, data and compliance. Campaigns that require social workers today can be staffed with more accessible, less expensive call center agents. And with an average ending member NPS rating of 9.2, members and agents alike vastly prefer empathetic conversations vs. scripted engagement.
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It's time to ditch the scripts!