Driving Breakthrough Member NPS and CSAT for a Global

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Driving Breakthrough Member NPS and CSAT for a Global Healthcare Payer

Faced with the challenge of stricter CMS regulations and the need to improve member engagement, a global health insurer partnered with Sagility. Our team got to work, and the insurer saw significant improvements in their NPS® and CSAT scores, along with a marked reduction in complaints.

Scenario

About the Client

A global health insurance provider sought to enhance member engagement while adapting to more rigorous requirements set by the Centers for Medicare and Medicaid Services (CMS). The client was navigating a transition towards stricter CMS protocols that required enhanced scrutiny and additional audits. The challenge, therefore, was twofold: to meet the heightened regulatory expectations and simultaneously improve member satisfaction and engagement.

Challenge

MS Requirements Transition

The client was making the transition to stricter Centers for Medicare and Medicaid Services (CMS) requirements. This shift meant that accounts would be under tighter scrutiny, with additional audits necessitating impeccable member service and communication.

Challenge

Member Engagement

Concurrently, the insurer sought to enhance their member engagement to provide a more empathetic and personalized experience, particularly focusing on the senior citizen market. Improving member engagement required an overhaul in training methodology, which meant the adoption of more sensitive, empathetic, patient, and accountable service provision.

Solution

Proprietary Training Methodology

Sagility employed an interactive training approach for agents based in its El Paso, Texas, site. The training program, specifically designed for the senior citizen market, emphasized empathy, patience, and accountability. This new training methodology not only equipped the agents to handle the specific needs of this demographic but also fostered a culture of sensitivity and patient customer service.

Solution

Enhanced Customer Experience

Sagility enhanced the client’s customer experience (Healthcare interactions) measurement approach by introducing defect analysis and action planning. These methodologies helped in identifying and addressing the areas of improvement in the client’s customer service delivery, thereby enhancing overall CSAT.

Solution

Optimized Resource Deployment

Sagility deployed resources to conduct an in-depth analysis of call details using raw survey response data. This analysis, based on mutually agreed rules, allowed the classification of defect reasons into Sagility errors and helped identify client-controllable issues related to process, technology, or customer limitations.

Solution

Text and Speech-Mining

Sagility leveraged advanced text and speech-mining capabilities to mine survey responses for additional insights. This technique facilitated the development of action plans to reduce controllable defects and further enhance the member experience.