Managing Health Insurance CX During "Crunch Times" and Year Round


When we talk about busy times of the year in the contact center, you might immediately think of Black Friday and the holiday selling season. But outside of the retail world, just about every other industry has its own version of “crunch time” – periods of high call volumes, long customer queues, and unusual strain placed on staff and technology alike.


For the health insurance industry, busy season tends to happen around open enrollment, with new and existing plan members calling in with questions about policy coverage, out-of-pocket costs, premiums, ID cards, and more. With these added challenges to consider, is your organization prepared to deliver the kind of customer experience that generates long-term loyalty and positive associations?

What Customers Want their Health Insurance Experience to Feel Like

When customers contact you, they want positive emotional experiences. If you deliver, they’re more likely to purchase again, forgive mistakes and refer others, according to Temkin Group. This is especially important in a confusing field like healthcare insurance, where customers need your help at their most vulnerable moments.

Simultaneously, customers want you to make your service efficient and personalized: Know who they are, and what their history with your company is, so you can reduce their efforts and resolve their challenges quickly.

Part of it means you need to understand the different cultures you serve, provide service in a variety of languages (75% are likelier to purchase again if you serve them in their own language), create accessibility options for people managing disabilities, and have technology that sets you to success.

Go Digital for Compound Growth

With so many new channels popping up on a regular basis, customers are used to getting the service they need when and where they need it. Besides phone, email and in-person service, customers see service via chats, apps and social media platforms as a basic requirement for purchase decisions.

Early adopters in the health insurance industry enjoy an advantage in customer acquisition and retention, because it’s easier to do business with them.

However, digital transformation is easier said than done in health insurance, as you probably have a complex system of products, integrations and sub-companies. Having your platform on premises doesn’t simplify the process either.

Transitioning to a cloud contact center can speed up your time to market with new products and customer service channels. It can improve your cross-channel flexibility and give you more options for integrations and functionality.

With a cloud contact center, you can create an omnichannel customer experience, where you know customers’ history across all the channels they’ve hopped between.

Acquire New Customers Without Sacrificing Long Term Ones

Going digital will help you serve Millennials, many of which grew up with computers from a young age, and Gen Zers, the newest adults, the digital natives who grew up in a multi-channel world.

It will also help you serve older generations, who have grown accustomed to the digital world through their workplaces, communication with grandchildren and the pandemic.

That said, providing an omnichannel customer experience will help you preserve long time customers who prefer traditional communications channels, such as phone and in-person.

Long term customers can influence their kids and grandkids to at least give you a try. One of our team members, for example, stayed with a provider longer than she would have otherwise, since her grandpa and dad swore by this company. She gave this company an extra chance because she knew the company has proven itself for her family across decades.

Of course, to preserve the younger generations long term, you must remember that their needs are different, and adapt your contact center to the everchanging future.

Automate Your Behind the Scenes Operations to Meet (or Exceed) Customer Expectations

As mentioned above, one of the key ways to serve customers well is to reduce their efforts. With automation, agents can see customers’ history across channels. Moreover, they can easily identify VIP customers.

In the example of our team member, a third generation customer would usually show up as a new customer in your system - even though she’s there, trusting you, because her family’s been a customer for decades. Similarly, you could have a startup customer that’s been referred by your largest Fortune 500 customer. Make sure every agent that serves these customers knows that. Otherwise, you may end up losing this rare new customer trust, and in really bad situations, your long term customers as well.

There are other ways you can use automation behind the scenes to serve your customers well, including:

  • Automatically surface explanations to guide agents based on customers’ questions, or surface chat responses and links they can send customers. This is helpful when you cover a wide range of health situations, that your agents can’t possibly memorize.
  • Automate shift management operations. Easily understand when’s the busiest time that requires more agents, or how many Spanish speaking agents you need per shift.
  • Automate quality assurance, to verify that the service you provide meets (or exceeds) customers’ growing standards.


Simplify Quality Assurance to Ensure Your Customers Always Have a Reason to Smile

Your ability to serve a variety of audiences and needs often depends on complex programs, company acquisitions and integrations. For example, you likely have hundreds of toll-free numbers, some of which are no longer connected, and you have no way of knowing it, because who has the capacity to review so many numbers?

Even if your team somehow managed to review every single number and extension, documentation would take forever, there’d be a ton of room for human error and… you’d have to do that over and over again to ensure nothing breaks along the way.

Automating this process enables you to get it done within hours, and regularly repeat it, to ensure customers can always get their questions answered via phone, IVR, chat… you name it.

The best part is that you can discover issues before customers do. This will reduce the unnecessary hours spent preserving customers that shouldn’t have had an issue in the first place, while other customers give you a chance to serve them instead of silently churning away.

You will feel customers’ growing sigh of relief and unwillingness to switch providers, since they finally found one that makes it easier to do business, a health insurance company that actually gets their needs.

If you do this really well, you might end up the subject of a conversation as, with a smile on their face, they encourage their friends to give you a try, too.