To treat a patient’s condition and to restore that individual to wellness requires a timely and accurate diagnosis of the ailment through a wide variety of methods and technologies by well-trained professionals.
The same goes for contact centers, and one of the most powerful tools available is speech analytics. By going through customer interactions and how agents and IVR/speech recognition systems communicate with them, it uncovers issues that could harm customer retention, agent performance and ultimately the bottom line – if left untreated.
BlueCross BlueShield of Tennessee (BCBST) knows the need for both effective patient and contact center diagnoses and treatment very well. It is the state’s largest healthcare organization, serving nearly three million people there and five million nationwide, paying 65 million claims and more than $17 billion in benefits annually.
BCBST has multiple business lines including government and commercial units, serving with a network of six contact centers and 250 agents. On the commercial side, it offers the “BlueCard”: a national program that enables members of one “Blue” company to obtain healthcare services while traveling or living in another Blue company’s service area.
BCBST’s BlueCard division is responsible for linking independent Blue Cross companies across the country. And to serve them, the healthcare firm has about 80 dedicated contact center agents who field over 400,000 inbound calls per year.
A few years ago, however, BCBST began noticing that the BlueCard division’s contact center team was showing some disturbing symptoms: that its call volume and average handling times (AHT) was continuing to spiral far above average and at alarming rates. While the overall organization experienced a nine- to 10 minute- AHT, the BlueCard team saw theirs grow to an average of 17 minutes: more than 70 percent higher.
While BlueCard could analyze AHT, the diagnostic tools it had were limited; it could only do so at an aggregate level. That meant that despite having multiple ways to improve AHT, including added training and improved agent scripts to developing online application BlueCard could not pinpoint which solution mix would address the issues.
Instead the BlueCard team mainly relied on talking and listening to the patients, i.e. contact center agents. It could not see deeply enough to find out what was causing the illness -- why customers were placing their calls. Without this ability to probe into the interactions to identify trends and understand the root causes, the BlueCard group did not know which treatments to administer that would cure or mitigate the conditions. Yet having this information could reduce its call volume, improve service metrics such as first call resolution (FCR), and boost operational efficiency.
“Although we had a general sense of what was driving up call volume, we simply did not have the tools required to dig under the surface,” said Maria Darras, director of BlueCard Operations for BlueCross BlueShield of Tennessee. “We needed to gain visibility into our contact center issues in order to reduce unnecessary operational costs. It became clear that if we were going to keep up with growing service complexity and industry challenges, we needed to upgrade our business intelligence and customer care capabilities.”
After careful research, BlueCard found a promising diagnostic methodology, Nexidia’s (News - Alert) QuickStart program, and introduced it into its practice in February 2009. QuickStart leverages the Nexidia OnDemand hosted delivery, incorporating Nexidia’s Enterprise Speech Intelligence (ESI (News - Alert)) speech application. ESI can integrate with multiple call loggers, which easily brings metadata into the system to be reviewed and analyzed and quickly process audio content, thereby permitting rapid root cause identification. The hosted method permits rapid startup: and results.
Working with the BCBST BlueCard team, the Nexidia analyst assigned to the account quickly understood the topics customers were speaking about, and what operational triggers were causing specific customer calls. They could then probe deeper into the underlying conditions and analyze the results. When they did, they found these issues, which were then treated:
The long AHT was caused by many incoming provider calls indicating they had sent BlueCard medical records that could not be found in the system. With Nexidia, BlueCard discovered that a simple process issue prevented agents from easily locating records. Missing provider cover letters were preventing records from being automatically imaged into the appropriate system for future retrieval and routing.
With this knowledge, BlueCard then identified those providers who were not sending their medical records appropriately and alerted them to review the appropriate filing protocol. The Nexidia solution also informed the BlueCard team to the need for specific types of training for its contact center agents. To boost FCR and improve group claims handling: assigning them to the appropriate agents for follow up, BlueCard needed to provide clearer training to its agents on the classification of specific call types.
BlueCard also identified where its website could be improved. Using Nexidia, BlueCard identified that the billing offices did not always receive important paper remittance advices that would be helpful in later conducting a claim status online. From this, BlueCard improved self-service options by enhancing its Web site to provide a link to the relevant remittance advice each time a provider updated a claims status.
“Nexidia’s technology gave us the ability to dive into what a member was calling about and better understand the customer’s issue,” said Darras. “Before, we were forced to guess at the reasons for calls and, as a result, aligned our strategy based on those assumptions. Now, with Nexidia, we are working with accurate information and can proactively streamline operations as a result.”
The results with the Nexidia hosted speech analytics were quick to achieve, tangible and measurable. AHT dropped to 12 minutes from 17 minutes -- a 42 percent improvement -- resulting in an estimated nearly $900,000/year savings. Call volume dropped 12 percent for calls related to “medical records needed to process claims not located,” saving an estimated over $130,000/year. Improved self-service options by updating its website to include links to updated remittance advices also reduced costs by diverting calls.
FCR was enhanced through managers employing the speech analytics technology as an agent training tool on specific types of calls. For example, BlueCard built queries around a forwarded call and work with staff that needed extra training on that scenario, thus helping to improve FCR. The staff was receptive to the opportunity for improving specific areas of their skill sets and witness efficiency gains, further enhancing FCR.
The prognosis? Excellent. In just four months BlueCard recorded a return on investment of over $1 million.
Based on this very positive outcome, Nexidia’s professional services and BlueCard’s internal team built a strong business case for adopting Nexidia speech analytics companywide. It was reviewed by key management at BCBST, including the CEO of BlueCross BlueShield, who subsequently green-lighted an enterprise license based on the results.
“The level of reporting detail in Nexidia’s system combined with its ease-of-use and hosted solution afforded us the vision into our customer calls that simply was not possible before,” said Darras. “We are so pleased with the results that we are actively rolling out Nexidia speech analytics to other departments such as: Membership, Member Benefits, Provider Service Organization, Medicare Advantage, Medicaid Admin and Medicare. As a result of using Nexidia, we were able to make effective changes to our contact center operations.”
Brendan B. Read is TMCnet’s Senior Contributing Editor. To read more of Brendan’s articles, please visit his columnist page.Edited by Tammy Wolf