In December 2003, HGS partnered with a US Fortune 100 Health Insurer to deliver voice and non-voice service for two of its processes, including enrolment and platform 1 pre-adjudication and adjudication. This service solution, delivered primarily offshore from Bangalore, India, was launched with just 15 agents.
This client’s case installation process was confronted with a series of customer information management challenges, all related to the complexity of enrollment and the wide variety of insurance products under consideration. The following problem areas were identified as particularly pressing:
These problems created serious customer experience problems for both insurance brokers and members. Additionally, the work required to amend and complete new patient records created delays in turnaround time for new accounts. For this process, this client asked HGS to achieve the following specific goals:
Based on our extensive experience with complex process consulting, HGS built an agent-friendly, web-based application, which helps to generate a detailed missing information database for all new members. This database was paired with a CRE tool that reviews all information collected before drafting, formatting, and populating individualized missing information letters, to be sent to new members as necessary.
Once our new tool was in place, HGS saw immediate and impressive results against all of the goals mentioned above:
Missing Information questions