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Blue Surface

The High-Tech Call Center

No one can yet deliver a chatbot that is as natural and

conversational as your call center reps.


No one has call center reps who are as well-informed

as a computer database.

High-tech call centers are now combining the best of both of these statements.

  • New technology acts as a virtual assistant for call center reps

  • Cognizant of all plan benefits and campaign goals the virtual assistant reacts to conversations and curates conversational scripts, real-time

  • This supplements call center reps’ subject-matter expertise, enabling them to confidently, and competently answer nearly any plan-specific question, on the spot

Plus, this AI-driven technology delivers

a by-member churn risk forecast.

We all know that scripted engagement calls tend to be one-way communication. Conversational engagement enables the health plan to get to know each beneficiary as a person. This approach is much more enjoyable for both reps and members. Plan literacy and utilization increase and complaints to Medicare decrease.

During conversations, reps are alerted to churn risk drivers that are identified by AI-driven technology. Scripts update automatically, prompting reps to discuss, unpack and diffuse the issues. Contrast this with scripted engagement where there is minimal feedback from the member and the rep is basically “zombied out” as they deliver the same scripted message for the 420th time this month.

Every PBP is segmented into four levels of churn risk. Managers are updated on the specific topics that mitigate or aggravate churn risk, by member. This information isn’t from last week, or yesterday – It’s real-time.

Churn Risk Assessment:

First Person Vs. Demographic/Socio-Economic Assumptions

Until now, predicting churn risk has relied on generalized data inputs. “This zip code is more likely to disenroll. This ethnicity or income level is at higher risk”. The results lacked specificity. First-person data inputs clarify who is at risk of churn and why. Churn drivers that were not resolved during the call are scheduled for second pass engagement.

These second-pass calls are conducted by appropriate experts:

  • Mrs. Smith needs a call from our Part D expert

  • Mr. Wythe needs a call from our Medicare Part A vs. Part C expert

Knowledge is PROFIT

This is the most significant advancement in call center technology since the CRM. Management knows that the rep, Beth, in cubical 8 (with single-digit forecasted churn) is a superstar, while John in cubical 21 isn’t cut out for this job because his forecasted churn risk is 30% higher than average.

two call center reps high-fiving

The culture within your call center changes with tech-enabled, conversational engagement. Instead of feeling like broken records who deliver the same message five times per hour, eight hours each day, reps learn about beneficiaries’ pain points and help to resolve them with plan benefits. Reps spend their days providing “moments that matter” that are appreciated by members. Our favorite question that clarifies whether your team could benefit from such an approach:

When was the last time you saw a high-five in your call center?

Member satisfaction, retention and LTV meaningfully increase as your call center gets pumped up about lowering short-term disenrollment by 10%, 20%, 30%.

It’s time to reimagine your call center. Click here to see PlanAllies™ technology in action.


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