As competition and regulations intensify in the healthcare payer industry, delivering positive member and provider experiences has never been more important to improving Net Promoter Scores (NPS) and Star Ratings. Problems such as unclear or missing information and claims adjudication delays can quickly damage reputation and create compliance risks if they are not resolved quickly and satisfactorily. Analytics are proven to help payers understand and act on complete customer journey insights so they can resolve issues faster, deflect or minimize interactions across channels, increase member and provider loyalty, and drive down the cost of engagement.
As an industry leader and innovator in interaction analytics, Firstsource provides a holistic, tailored approach to customer interaction analytics for healthcare payers – backed by premier contact center expertise managing about 200 million customer interactions and analyzing more than 10 million customer interactions per year.
Our award-winning First Customer Intelligence (FCI) technology leverages speech and text analytics to capture and analyze member and provider interactions and feedback across multiple communication channels. FCI brings structure to unstructured interactions and combine all data sources to arrive at actionable insights that drive improved service and operational efficiency. By analyzing large volumes of interactions, we get to the root of why customers contact your call center. We then categorize entire interactions, develop strategies to direct customers to cost and time appropriate channels, identify opportunities for contact avoidance and call deflection, and help healthcare payers understand:
Our speech and text analytics technologies analyze customer interactions from multiple sources including voice, web and mobile chats, correspondence, online forums, emails, social media, blog comments, and customer satisfaction and NPS surveys. We combine phonetic recognition and transcription on audio files and metadata, rule-based categorization and emotion detection to detect the cause of problems, the process of resolving them, and member/provider levels of satisfaction throughout the experience. By leveraging Natural Language Processing (NLP), we can establish semantic relationships and understand the full context of conversations to enable healthcare payers to improve agent performance, optimize interactive voice responses (IVR) and automated compliance checks, and correct specific customer issues.
Call sampling and traditional quality monitoring are no longer enough to truly understand customer journey or provide insights payers need to drive the best interactions. Our proprietary First Customer Intelligence (FCI) framework and methodology uses a multi-layered approach focused on interaction trends and patterns, agent performance, and business impacts. This includes understanding the actual reasons for contact, tracking the emotional experience, mapping end-to-end journeys, and determining and resolving the root causes of problems.
Using advanced tools and expertise, our analysts build custom taxonomies, categorizations and reporting structures after examining the conversations specific to a payer’s business objectives. We take a deeper dive to examine trends and patterns for call reasons, such as claim denials and EOB related issues, what they are saying, how they feel throughout their experience, which journeys are causing levels of dissatisfaction and their root causes. We also use keyword analysis to detect online competitor mentions and members’ assessment of their experiences.
Furthermore, our FCI platform continuously expands its understanding of your specific process and customer interactions. We use taxonomy and libraries that take into account local speech and text nuances, detect positive and negative experiences, and provide contextual heat mats to deliver a complete, 360-degree view of the customer experience – and pave the way for more effective issue resolution and improvement.
Payers must have constant insights into the business impacts of all customer interactions in order to drive ongoing improvement across agent and advisor performance, customer satisfaction and resolution, and business results. With a complete view of member and provider journeys across all channels – calls, chat, IVR, text, web and self-service – combined with quality monitoring, FCI provides a delivery framework that empowers payers to focus on reducing risk, ensuring compliance, increasing revenue, building customer loyalty, and enhancing operational efficiency.