Case Study: Telesolutions for Complex Health Plans
For several years, DialAmerica Healthcare Solutions has partnered with a disease management company that is dedicated to offering healthcare programs, services and products to the underserved and those with chronic illnesses. Currently, DialAmerica Healthcare Solutions is supporting their Medicare Advantage Special Needs Plan for the chronically ill, Care Improvement Plus (CIP). The client is committed to delivering quality healthcare through a combination of medical coverage, prescription drug coverage, health education and additional benefits.
This specialized plan requires a contact center solution that can handle not only the volume from prospective members, from five different states, but understands complex healthcare programs and has agents who can effectively communicate sensitive information. Additionally, once prospects become beneficiaries of the plan, there is an on-going need to provide support to the members and corresponding providers.
Situation / Objective
DialAmerica Healthcare Solutions needed to accomplish the following program objectives for CIP:
- Ramp-up a call center solution quickly enough to support five new markets while not sacrificing the quality and care of new members and doctors
- Help educate the chronically ill Medicare population and provider network on a new type of plan in the area
- Navigate members and prospects through the ever-changing healthcare compliance landscape
- Be able to forecast call levels for new members and providers
The DialAmerica Custom Solution
DialAmerica Healthcare Solutions delivered a tailored solution by executing the following:
Created an incentive based program for agents. Excellent performance enabled the agents to advance and earn more through additional duties.
- Co-authored a specialized training program. Agents were on-boarded in a timely manner and equipped with the necessary skills needed to handle the calls.
Presented and executed scalability plans. Customized plans ensure that service levels could be maintained during fluctuating call volume periods.
- Created repositories of feedback for the client. This enabled CIP to quickly learn of and address issues faced by members and providers.
- Drew upon past experiences. DialAmerica Healthcare Solutions? previous work in the Medicare space helped ensure CIP was compliant with all Medicare Marketing guidance.