Health Insurance Contact Center Improves CSAT and Quality Scores with Vistio and AgentHub

Challenge

Like a lot of Health Insurance contact centers, a Vistio client recently faced challenges handling a high volume of calls that involved very complex processes. The contact center had been suffering from lower than expected quality scores and CSAT scores which concerned management. Other concerns included avoiding any PHI (Protected Health Information) violations or providing incorrect guidance. As one call center manager said, “Health insurance can be a very murky topic so we need to be a trusted source of information. Afterall, we’re not just solving customer complaints—our efficiency and accuracy could directly translate into people leading better lives.”

The health insurer felt that they lacked visibility into what was happening in the call center and as a result, they had very little actionable data on which to base decisions. For example, their statistics on basic call center metrics like handle time and calls in queue were unreliable. But, they also didn’t have visibility into the main call drivers and the volume of each call type. Therefore, leadership couldn’t focus on training agents on the most common call types and they couldn’t anticipate how many agents would be needed to handle the volume of calls coming in.

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Often, call volume would be higher than anticipated and agents on the floor would be overwhelmed, so back office agents, who hadn’t been fully trained, were enlisted to take calls. Other times, significant and regular changes in legislation made it difficult for even the most experienced agents to know the proper procedure for handling each call type, further increasing handle time and errors while keeping customer satisfaction scores low.

“AgentHub is going to be your best friend. It saved me many times.” — Health Insurance Contact Center Manager

And finally, the client had just finished construction on two new physical locations, but they were forced to have their agents work from home, so they had to quickly figure out how to manage agents remotely and how to deal with IT issues like dropped calls, audio quality issues, and problems with connectivity and network speeds.

Solution

The Health Insurance contact center enlisted the help of Vistio to improve their metrics, to get better visibility into their call center performance and staffing needs, to assist with their transition to agents working from home, and ultimately to better serve their customers.

Before implementing any software, the Vistio team helped the client identify which call types were most important to address first. Combing through three years of de-identified historical data from the client’s CRM helped the Vistio team determine what call types were most common. They also worked with the client to identify which calls most often result in critical fails, which calls were the most complex, and which calls resulted in regulatory penalties if they were handled incorrectly. Additionally, the Vistio team standardized the client’s caller authentication process to eliminate the risk of providing information to an unauthorized caller.

“Having something that is there to support you, that breaks the job down step-by-step, and that tells you what to say is huge. Everything you need is right in front of you.” — Health Insurance Contact Center Manager

Working with the client’s subject matter experts, the Vistio team then converted all of the client’s standard procedures and training materials into over 100 AgentHub workflows that addressed the client’s most pressing challenges. One of the new workflows, for example, was designed to handle calls about new expanded tax credits and subsidies offered through the new ARP (American Rescue Plan) legislation. Each workflow guided the agent through the exact steps necessary to complete the call successfully and included suggested verbiage that helps agents know what to say while handling specific issues.

During the implementation, very little time or effort was required from the client’s IT team, as the Vistio team handled the majority of the implementation and integrations. And because AgentHub could now guide each agent through the correct steps to resolve most customer inquiries, agent training could focus more on soft skills instead of memorizing processes.

Results

Once all of the agents were trained on the proper use of AgentHub, the call center’s quality scores and CSAT scores began to quickly improve. Over a three-month period, the average quality score increased by just under 20% from 75.71 to over 90. During the same period, overall CSAT scores improved by 5% from 88 to almost 93 out of 100, capturing over a third of the remaining possible score. While metric performance improved, AgentHub also reduced the amount of stress agents faced on each call, increased first call resolution (FCR), and reduced after call wrap time using AgentHub’s auto documentation and disposition functionality, all of which led to increased employee morale and reduced attrition. “Having something that is there to support you, that breaks the job down step-by-step, and that tells you what to say is huge,” according to one call center manager. “Everything you need is right in front of you.”

Using new AgentHub workflows for customer authentication now meant that 100% of callers were authenticated correctly. Training time was also significantly reduced from three weeks down to two weeks as over 200 new agents were hired, fully trained, and ready to hit the call center floor within one month.

As the contact center’s overall performance began to turn around, management noticed that using AgentHub cut down on the number of updates and job aids they needed to give to their agents because all the information agents needed was now in AgentHub. Similarly, the number of questions management would get from the floor over the course of a day decreased by about a third, allowing managers time to develop and mentor agents rather than constantly addressing urgent issues. As one manager noted, “I get to focus on areas that were lacking like certain sections of quality.”

Using telemetry data from AgentHub, the call center gained a new level of understanding about what was affecting their performance. They were now able to see in real time the frequency with which customers called about specific issues and how the contact center was performing relative to its goals for CSAT and quality, and they were more able to accurately predict how many agents they would need to handle fluctuating call volumes. They were even able to see which agents were using AgentHub correctly and which were not; some more tenured agents were initially reluctant to adopt AgentHub but the Vistio team identified those agents based on their user behavior so management could give them additional coaching.

As the contact center continues to work closely with the Vistio team, they have expanded AgentHub’s functionality by adding close to 50 new workflows to handle different customer issues, bringing the total number of workflows to close to 150. The Vistio team is also working with management to constantly improve AgentHub’s functionality, releasing revisions and new workflows almost weekly.

Going forward, due to the positive impact AgentHub has made on their front office operations, the client is now in the process of implementing AgentHub workflows to assist their back office employees as well. They also plan to increase the number of workflows for their escalation team, helping those agents solve even the most complex calls efficiently and accurately.