August 2009 FEATURE ARTICLES
Call/Contact Center
Presbyterian Improves Customer Experience
Call center transformation involves software to create business rules for virtually any contact type, while improving the customer experience and access.
The medical care provided by Presbyterian Healthcare Services, New Mexico’s only private not-for-profit healthcare system, has been consistently rated top notch, but medical care is only a part of the customer experience. In delivering customer service, Presbyterian faced challenges that included difficulty in navigating a complex set of organizational silos, such as insurance, scheduling, billing and appointments. Presbyterian wanted to improve the level of its customers’ satisfaction when they interacted through its contact centers and throughout the customer experience. This meant taking a fresh look at all aspects of the process.
Founded in 1908, Presbyterian operates seven hospitals and 34 clinics, and serves more than 700,000 customers throughout the state, with annual revenues of more than $2 billion. As an integrated healthcare system, Presbyterian also offers a healthcare insurance plan, Presbyterian Health Plan.
"In healthcare, there is a great deal of built-in complexity and a variety of programs, such as Medicare and Medicaid, that require certain training and skill sets, so it is challenging to be able to quickly route inquiries and consolidate customer service to make it easy for the consumer," says John Johnson, director of customer service for Presbyterian.
"When our members think of Presbyterian, they value the community aspects of healthcare, including local staff and doctors," he adds, "but we also wanted to create an environment where the customer experience was the same across the entire enterprise."
Even in areas where staff sought to increase the use of self-service and automation, Presbyterian focused heavily on improving the customer experience and access at the same time.
Presbyterian had many different locations where calls were handled, creating a fragmented service experience. A single call might require multiple transfers, or the customer calling back in. Many inquiries would require help from different functional areas, such as billing questions, scheduling appointments and coverage issues. The goal was to centralize customer service where appropriate, but also to retain local access for tasks that were best handled outside of the contact center.
Presbyterian has a contact center staff of 130 representatives across multiple centers around the state. In addition, it has regional hospital facilities and primary care clinics, with staff located in smaller communities, as well. With its regional sites, having staff from the community handling calls was important.
A Single Customer-service System
Presbyterian reviewed service-center improvement as part of an enterprise transformation effort, including such key technology-driven efficiencies as enabling multiple contact channels, proactive customer contact, leveraging virtualization and driving business-process improvements. One of its biggest challenges was to create a single customer-service system that supported a variety of customer needs, including flexibility, simplicity, personalization and efficiency.
"Our intent was to create a more seamless, ‘One-Presbyterian’ view of customer service, so customers didn’t feel they were dealing with so many different organizations," Johnson explains.
Within the Presbyterian Customer Service Center, staff undertook a project to integrate three main areas that comprise about 75 percent of the customer service volume coming into any customer service area in the company: patient financial services, which handles physician and hospital billing; member services, which supports members from the health plan that is owned by Presbyterian; and primary care scheduling for primary care clinics.
Even in areas where staff sought to increase the use of self-service and automation, Presbyterian focused heavily on improving the customer experience and access at the same time. All of its efforts followed a rigorous Six Sigma design process, with results closely monitored and measured.
After its initial assessment, Presbyterian identified dozens of areas for potential improvement. While much of its brand promise to consumers, for example, was based on the idea that there is "one Presbyterian" that can meet all of their healthcare needs – from insurance to medical care – the system had grown to more than 100 unique phone numbers that customers needed to navigate depending on their needs.
"We wanted to simplify matters and create a single point of access, incorporating the Web, self-service and assisted service," Johnson says. "To do so, staff catalogued each of the business processes associated with hundreds of customer interactions."
Software Does the Trick
After capturing and categorizing the business processes, Presbyterian used Genesys software to create business rules for virtually any contact type, including eligibility, claims, physician assignment, plan questions on more than 100 plan types, co-pays, scheduling physician appointments, payments, balance inquiries and physician inquiries. To ensure consistency, each business process could be deployed once, but would drive interactions across multiple customer systems, from the Web to voice self-service. After that, the Presbyterian team re-designed many of the processes and was able to reduce the number of steps by 46 percent.
"We also implemented workforce management to ensure that staffing was optimized across 25 different sites," Johnson explains. "Leveraging skills-based routing, staff was able to identify the right resource for each incoming call and route the caller accordingly. In addition, if hold times grew too long, we offered any incoming caller the opportunity of scheduling a return call using ‘virtual hold’ technology, which allows a customer to choose the time and location for a return call."
A proactive contact capability can initiate outbound voice calls, such as issuing an appointment reminder. Using IP technology, Presbyterian can use a single platform to route calls anywhere, as appropriate.
Presbyterian reviewed service-center improvement as part of an enterprise transformation effort, including such key technology-driven efficiencies as enabling multiple contact channels, proactive customer contact, leveraging virtualization and driving business-process improvements.
The end result was an integrated customer-care system that brought together a complete range of technologies, including the Web, live agents, automated voice, patient options for scheduling proactive call-backs from key contacts, and business processes.
While seeing a 218 percent increase in self-service options, and an 8 percent increase in the uptake for automated systems, Presbyterian also saw customer satisfaction increase by 44 percent. Overall, Presbyterian also showed an 18 percent increase in efficiency, taking into account both assisted and automated assistance. Along with the increase in customer satisfaction, Presbyterian has seen significant cost savings as a result of efficiencies and business-process improvements.
For more information
Genesyslab solutions
From the Catalog
According to www.genesyslab.com: Genesys provides a comprehensive and open product suite that ties any customer interaction and an organization’s resources together to better manage the contact center workforce, with reporting and analytic tools. Genesys delivers an open call center platform design that integrates with many leading hardware and software systems. The Genesys Customer Interaction Management Platform is at the core of the costumer contact center software solution that routes and processes interactions across the healthcare organization, connecting customers to the right resource.