In a market increasingly dependent on delivering exceptional customer experiences, payers must innovate their processes and offerings to meet member expectations — or risk being left behind. 

To accomplish this, healthcare payers must focus on improving their customer touchpoints. While a member contact center is typically the first point of communication for members, conventional telephony systems don’t always provide a smooth experience. According to a study from JD Power, 1 in 4 consumers waited 10+ minutes to speak with a live representative in 2020. This all-too-common experience can leave members frustrated and service representatives overwhelmed.

Cheryl Gibson, Gerent’s Senior Director of Healthcare and Life Sciences (HLS), proposes a solution: “By investing and prioritizing the consumer experience via a digital member service center, payers can not only improve their member’s satisfaction and retention but also increase revenue and reduce expenses through operational efficiency.”  

Delighting your members with an industry-designed member services solution is the way forward for efficient service operations and top-rated customer service. Our consultants have firsthand experience with pain points in the industry and have driven solutions to address those stressors. While daunting, this transition doesn’t have to be difficult — there is a way forward that optimizes results while staying mindful of budget.

Optimizing Member Experiences Through a Payer-Focused Member Service Center Solution

The bar for meeting consumer expectations has never been higher. According to a survey by KFF, about 58% of insured adults report experiencing problems using their medical insurance in the last 12 months, including those insured by ESI (60%), Medicaid (58%), Medicare (51%), and Marketplace coverage (56%). 

Payers need to wield a digital solution that streamlines operations to stay ahead of the curve — and Gerent’s proprietary Smart Start empowers our customers to do just that. As a pre-packaged solution powered by Salesforce’s Health Cloud, our Member Service Center solution is built according to industry best practices, enabling payers to provide members with smoother and more satisfactory experiences. This solution encompasses 60-80% of the pre-configured features and capabilities payers need to serve their members effectively at scale —and maximize return on investment.

Why choose Gerent’s Smart Start solution?

Our Member Service Center Smart Start addresses common challenges (e.g., triaging member calls, facilitating information updates, etc.) and delivers fundamental Salesforce functionality on a quick turnaround. It’s also fast and flexible; payers can tailor their solution to best fit their needs with customization options. This, coupled with Smart Start’s emphasis on end-user experience, ensures that payers get the capabilities they need without exceeding their budget or overstepping their preferred timeline. 

Key features of our Smart Start include:

• Intuitive Interface for Service Representatives. Our console empowers customer service representatives to get the full picture when a member calls. With immediate access to important information such as member details, plan benefits, claim history, ongoing cases, and communication preferences, this is the one-stop shop for immediate, personalized service.
  
  
• 360° Member Insights. Customer service reps gain 360° visibility. Our Smart Start integrates Salesforce with our clients’ existing phone systems so member services representatives know who each caller is. At the beginning of every caller interaction, Salesforce surfaces a rich profile that includes details about the member’s basic information, PCP assignment, inquiry history, claim details, and more. 
  
  
• Action Panel. Handle common concerns with ease. The action panel provides shortcut links to tools representatives need to complete high-frequency tasks such as creating service inquiries, viewing or requesting an ID card, changing the member’s PCP, searching for in-network providers, updating personal information, and viewing or uploading documents.
  
  
• Priority Action Alerts. Target high-priority tasks so reps can make the most of their service interactions. With a built-in Alert Panel, important tasks like updating missing member information will be immediately available when a member calls.
  
  
• Omnichannel Member Support. Give clients the experience they crave. Utilize top-tier omnichannel experiences to create meaningful engagement with payers.
  

“Gerent’s Member Service Center solution was designed exclusively for payers and is intended to provide a strong foundation that is scalable for the future,” Gibson explained in an interview. “By empowering their member service representatives, payers can increase efficiency and improve members’ experiences while reducing implementation costs and implementation time.”

Leverage a Smart Start Solution with Salesforce

Implementing a new Member Service Center may seem daunting, but with the right implementation partner, it doesn’t have to be. Gerent has the experience and straight-to-value methodology necessary to drive results — with 160+ years of Healthcare experience and 1,000+ collective years of Salesforce experience. Our industry knowledge and past payer project experience can add value to a payer by:

• Increasing Member Satisfaction. Being member-centric is key — Gerent implements solutions that empower payers to meet members where they are.
  
  
• Improving Call Center Statistics. Through the automation of complex inquiries and improving First Call Resolution, payers will be able to improve their call center satisfaction rates.
  
  
• Providing a Strong Foundation. With an experienced partner, payers can leverage the platform to adapt readily to the future.
  
  
• Maximizing Investment. At Gerent, we are hands-on — we’ll install Salesforce’s Health Cloud with Omnistudio and tailor it to fit our client’s needs; we also offer integration assistance with the payer’s claim system to maximize the solution.

Put simply, Gerent has the expertise necessary to drive results. We’re a five-star, Summit-level implementation partner; get the most out of your investment by trusting us with your software solutions.

If you’re interested in hearing more about what our Member Service Center Smart Start can do for your organization, check out our industry microsite or contact us to start a conversation.