Foremost American healthcare company innovates across the entire care continuum

Choosing the right health insurance plan deeply impacts the quality and affordability of care options. Helping members choose the right plans for their health needs and supporting them in making the right care decisions could be a significant competitive differentiator for healthcare payers.

For a leading U.S. health solutions company, relying on third-party providers for enrollment was proving costly – both in terms of profitability and customer experience. In addition, the lack of a unified customer relationship management (CRM) platform affected the ability of customer service representatives (CSR) to assist members. A more modernized approach was needed across the care continuum.

To achieve this digital transformation, expert engineers were needed to bring the future to life with frictionless, even beautiful moments at the intersection of software and human experiences. It was critical to boost CSR effectiveness, reduce the cost of service, and improve the customer experience.

Engineering excellent care

Ascendion engineers partnered with the client to map the member’s journey and identify areas of improvement. We transformed the member experience with a new self-service portal. We created an intuitive, user-friendly member portal with comprehensive self-service capabilities for search health plans and benefits and customer support.

We designed a decision support system for the CSR team. We also built an analytics and machine learning-led unified decision support system for the Customer Service Representatives with a 360-degree view of the customer information to offer personalized support and enable proactive outreaches to members if required. Ascendion co-engineered the member portal and CSR portal that now offer:

• Best-in-class UI design imbued with accessibility principles for universal access
• Secured patient health information with data encryption
• Ease of quote retrieval for members via email with pre-filled customer-specific URLs
• Appointment scheduling on prior consent to discuss a custom quotation
• Detailed reporting based on user activity to understand crucial metrics such as bestseller plans, best target market, overall revenue, members enrolled, etc.
•  Comprehensive plan search experience powered by seamless third-party integrations
• Scalability and ease of maintenance with logic from different consoles consolidated into a single module
• Low-code capabilities with migration to Salesforce Flows and point and click configuration for the front-end coding needs
• Member data analytics across engagement channels that provides CSRs with the ‘actionable outcome’ recommendations

Modernized meaningful healthcare moments

• 6% reductionin overall healthcare costs for members with tailored and timely health and wellness information; 20% reduction of targeted member healthcare costs
• 13% increase in CSR campaign output with more effective outreach
• 9,000+ CSRs improved experience and productivity
• 30% reduction on average customer query handling time

Ascendion has helped numerous organizations succeed in their digital transformation and experience efforts. Talk to us to learn more.