Healthcare Customer Care Management Climbs Out of the Box

Since 2013, Healthcare Customer Service Outsourcing has been the fastest growing outsourcing BPO segment. The introduction of Health exchanges through Obamacare (Marketplace), the U.S. ICD-10 conversion in 2015, and the growing population of educated patient/members who have a choice in their healthcare insurance carrier and provider, have all contributed to this growth. Additionally, as we face the beginning of 2017, the payors such as United Healthcare, Humana and Aetna/Coventry are closing their Marketplace plans, forcing members to find a new insurance carrier. The newly elected administration brings rumors of repeal or significant changes in Obamacare, and with it come questions concerning patient eligibility for care, access to providers, and insurance coverage. Before we finish the list of changes that have perpetuated this growth in the industry, let us not forget the onset of TeleHealth, which provides virtual access to nurses and physicians. The need for quality, mature, and skilled customer service agents has not stopped climbing. Healthcare organizations are challenged with finding, hiring, training, and staffing in an unpredictable environment, or realizing the costly burden to adequately hire a safe cushion of agents to handle this unprecedented volume. The solution is to seek resources outside of their four walls. 

As expected, the above changes and progressions create a plethora of questions, misunderstandings, and confusion for patients and members. Subsequently, it breeds increased call volume to providers and payers for scheduling, basic triage, registration, enrollment, coverage, and potential in plan provider listings. Patients need to speak to an educated, caring, mature, healthcare customer service agent who can provide key information, clarification, guidance, support, and ultimately peace of mind regarding their healthcare plan and care.

Fast forward: Once Healthcare organizations climb outside their four walls and discover the Arise platform, they realize there is an ideal alternative and realistic solution to their customer service challenges: 

The platform can facilitate access to mature, trained, quality customer service resources with healthcare backgrounds and who are entrepreneurial and passionate about helping others, at a very affordable cost

The platform can handle spikes in volume for Monday calls or end-of-the-month surges in billing inquires

The platform provides access to unprecedented flex to meet those unpredictable call volumes even when they are 40% over forecast so no call is missed.

The platform provides access to a superior level of customer service and patient/member engagement that routinely outperforms in-house and competitive environments to ensure their patient and members continue to come back.

If you and your healthcare organization are finding similar challenges, feel free to reach out to Kim at Klayne@arise.com

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About the Author

Kimberly Layne, Vice President, Business Development – Health & Life Sciences, brings over twenty years of healthcare experience and expertise in working with Physicians, and C-Suite Executives within pharmaceuticals, medical devices, and Healthcare Organizations seeking best in class performance in services, technology, and outsourcing.

Her breadth of experience in the healthcare marketplace is coupled with creativity, a passion for her clients, and Lean Six Sigma Certification in order to deliver customized and innovative solutions with a strong financial impact.

Kim holds an M.B.A from John Carroll University, and is also very involved in supporting women’s initiatives locally through the YWCA and the prevention of cruelty to animals through the ASPCA.