The growing importance of patient satisfaction and first call resolution


Providing first-call resolution through a healthcare plan's call center is critical to customer satisfaction.

Patient satisfaction is a key performance metric associated with the Affordable Care Act (ACA) and an increasingly crucial determinant of a healthcare organization’s success.

Healthcare plans and hospital systems especially need to think seriously about patient satisfaction on all levels. Blues plans, for example, have implemented Member Touchpoint Measures related to timeliness and accuracy measures in customer service.

There are a number of things that health insurers can do to deliver better care and improve customer experience. And, in the context of the healthcare contact center, first-call resolution is crucial.

Timely responsiveness to inquiries, when combined with clear solutions to problems, is paramount in the minds of consumers today. That expectation applies as much to healthcare as to any other vertical market.

So, how can a stakeholder with a contact center requirement ensure high first-call resolution rates?

  • Focus on real knowledge and infrastructure
    Scripts will not solve beneficiary and patient problems, but knowledgeable agents supported by the proper infrastructure will. Agents should be trained extensively about common issues and have the understanding and assets in place to quickly transfer inbound calls to the right channel in order to maintain first-call resolution. Furthermore, transfers need to be seamless, with pertinent member information moving through the service chain alongside them, to discourage transfer-related drops and increase resolution rates.

  • Focus on live interactions, not automation
    Focus on live interactions with agents rather than complex, automated answer systems. This is not an overly expensive route to take when one factors in the cost-savings of quick resolutions that well-trained agents can deliver.

  • Consider unexpected needs
    Remember to include all services that might be needed, not just now but in the future. For instance, if members have multi-language needs, or if there are requirements or situations where after-hours service is needed, solutions should be built into the program from the outset. A capable contact center should be able to help predict unexpected requirements and strategize the best ways to meet member needs.

  • Work with the best
    There are a litany of call center options, but only a few offer healthcare industry experience and licensed agents. The agent training and communication infrastructure required to operate successfully in healthcare is a high bar to reach. Selecting a capable partner is crucial.

As the healthcare industry continues to adjust to ACA implementation, and as other delayed tenets come on line in the future, maintaining first-call resolution at healthcare call centers will be necessary for stakeholders to deliver optimal customer service.

Rich Smith is vice president of business development at DialAmerica, where he's responsible for helping develop customized customer contact solutions for the company’s healthcare clients.

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