Digital communication in health insurance service centers

In many health insurance companies, each customer has a dedicated personal customer consultant whom they can contact with their concerns via a personalized telephone number and email address. If the personal customer consultant is not available, the substitute arrangement, which can be of varying granularity, comes into play. It must therefore be possible to map given organizational structures in the routing in order to ensure flexible distribution of enquiries. Existing substitution rules are either stored on the customer's own systems or on the contact center system and form the basis of the routing strategy. These requirements are implemented using the so-called “waterfall” routing model. In this model,  skill-based routing can also be implemented.

With the help of the master call flow concept, we offer health insurance companies the possibility of processing large volumes of existing and incoming service numbers using the same type of call distribution (call flows). Together with the customer, we define so-called master "call flows" which reflect the processes and basic procedures of the call distribution. Via corresponding variables in the master call flow, the parameters valid for the respective service line are then read out from a database and made available to the call flow for concern distribution. This means that a master call flow can be completely parameterized and can be easily instantiated with additional service numbers/email addresses, for example for upcoming customer and marketing campaigns. This not only increases the flexibility and speed of implementing new business requirements, but also reduces the overall costs of operating the solution. Advantages include:

• Simplified operation of service center systems with many dial-in numbers.
• Few master call flows in the system. Each service number or email address defines one instance of the master call flow.
• The operation and support of the system is massively simplified because the call flows are standardized.
• When creating new service lines, only one additional line has to be defined in the database with all associated parameters.

Thus, employees of health insurance companies work with the same application (CCE). This enables quick integration of necessary and free resources into the service center and good working conditions. 

• During normal operation, fewer customer service representatives are needed as the specialist department can help out in case of overload.
• Sharing the system increases common understanding and fair workload distribution.
• Even the IT help desk can be integrated if desired.
• Everyone has the same omnichannel capabilities.
• Unified reporting and analytics become a breeze.
• Communication and interaction between insureds, customer advisors, specialists and external suppliers is free of media discontinuity and is evaluated and analyzed holistically.
• Tested and established in practice. Matthias Rose will gladly provide you with concrete references.

• Further data from any source and department can be integrated and operated by the customer itself or by Bucher + Suter in the CCBI data model.
• b+s CCBI is available as a stand-alone solution or as an add-on to b+s Reporting (call-by-call database server). In the cloud solution, the Power BI Gateway is installed on a server with an internet connection and delivers the data from the customer's b+s Reporting to the Power BI data model in the Microsoft Azure Cloud.
• Depending on the customer's Microsoft licensing, the update schedule is defined, and a dedicated cloud instance is used if necessary.

• Focus checkbox for easy differentiation of service level relevant objects.
• Freely definable short call threshold.
• Skill group and precision queue consolidation.
• Display of data availability across all data sources.
• Organizational groupings (BU/OU) facilitate segmentation of rights.
• Data-independent date and time calendar for selecting and displaying data.
• Retention of all configured objects, even if they have been deleted in the CCE.

• All common contact center KPI.
• Purpose-built interactions between all charts in report templates.
• Language dimension allows analysis of demand and existing language skills.
• Location parameters for agents allow geographic analysis.
• Primary queue reporting.
• Originator (ANI) dimension and filter also allow recaller reporting.
• Service level scenarios in 10 steps from 10 seconds to 20 minutes.
• Inclusion of agent and department utilization.

Data models and report templates are published in the customer's workspace. User segmentation of the data is done in advance based on predefined roles and “row level security”. Assigning roles allows easy management of access rights for the different users within a workspace.

Demarcations

The licensing of Power BI is the responsibility of the customer and not part of the solution. Capacities and limitations are largely dependent on this and can also be increased incrementally. The responsibility for publishing the data in the Azure Cloud and managing the access rights for the users lies entirely with the customer. This also includes compliance with country-specific data protection regulations.

Limitations

In the b+s CCBI data model, not all data of the reporting database is available (redundancies as partly not useful). Which measures are included with which release can be found in the specification of the data model.

Contact center inbound across all channels (voice, chat, email, tasks)

• Agent status times
• Direct calls

Is this the beginning of another success story? Share this information with analysts and service center managers in your organization. We're ready when you are!