Avatars help improve Medicare's annual enrollment period customer satisfaction

December 15, 2015 Ray Catudal

Medicare’s annual open enrollment ended December 7th. We haven’t heard the total amount of enrollees, but it’s likely that this year health insurance carriers will again have sold more Medicare policies than last year. I expect to see additional growth, especially in the Medicare Advantage business.  With more enrollees, call centers can expect more questions coming in, not only due to the increased volume of policy holders, but also due to the 2016 changes on premiums, out-of-pocket limits and other plan features.

The big concern

A big challenge is going to be explaining how prescription drug deductibles work, a feature expected to be present in almost half of all Part D plans, according to a KFF study. Many studies show that understanding deductibles is still a major challenge for individuals. To add chaos to confusion, there are five different drug tiers: preferred generic, generic, preferred brand, non-preferred brand, and specialty tier. If that wasn’t enough, some drugs tiers have flat copayments, others have coinsurances, and they differ if you chose mail order. Are your agents prepared to explain this complex breakdown or guide members to a so called “network pharmacy”?

Nothing is being more discussed than drug costs nowadays. For example, a 2015 survey conducted by the Harvard School of Public Health found that many people are concerned regarding the high brand name drug costs and the lack of the government involvement to alleviate these drug prices in the Medicare program.

Save money and time with a digital solution

After continually explain deductibles, pharmacy networks, and drug costs, perhaps you’ll be fed up with the amount of time your live call center agents are on the phone, and you’ll add a virtual agent to the chat and call back functions already present on your site. Let’s be honest, the average Medicare consumer is faced with 19 different Medicare Advantage plan choices, spurring a large quantity of calls asking live agents to repeatedly explain components such as deductibles, pharmacy networks, and drug costs. Is explaining how a pharmacy network works the best use of your call center agents time? Even the best telephonic needs analysis will tie agents on the phone for 60 - 90 minutes. There is a way to reduce these types of calls.

Offer Medicare beneficiaries the option to do as much research upfront with the aid of an interactive avatar that will answer the most frequently asked questions before a call is ever placed? A site that is easy to understand, offers interaction, and is informational is the site people will favor enrolling on.

Virtual assistants can certainly do their share to make consumers feel comfortable, including providing consistent high quality answers. Newly trained seasonal agents that may make wrong comments and rush beneficiaries through the process ‘just to get the sale (and incentive)’.

As CMS ramps up its enforcement efforts around formulary, benefit and marketing noncompliance, carriers should take a closer look at the value that virtual assistants bring. Leveraging avatars that use CMS pre-approved scripts could reduce the amount of time compliance departments spend with official complaints and grievances about call center agents failing to follow protocol. Virtual agents routinely communicate the same pre-approved script, providing high quality, compliant answers. Avoid being on bad terms with CMS, as happened to one large carrier.

But how?

If you’re interested in reducing the amount of telephonic enrollments and increasing the amount of online enrollments, you can turn to CodeBaby. We can help reduce your abandonment rates, average speed to answer (ASA), talk time and hold time while increasing your information accuracy rate.

Last but not least, if you’re looking for ways to better serve newly eligible Medicare shoppers, find out how avatars can explain the Low Income Subsidy (LIS) or “Extra Help” calculator for Part D. In a world where benefits are regulated and competition is hard to accomplish, Avatars make a difference. Turning online transactions into social conversations allows difficult procedures to be explained, making the web less lonely and technology easier to use. Imagine all the cost and headache you can save by eliminating the call center staff ramp-up each enrollment season.


Like what you read? You might be interested in these, too: 

Are you making it easier for people to enroll in Medicare?

CodeBaby launches Medicare expert virtual assistant to help increase online enrollment and reduce call center costs

More tools are not the answer. More personal guidance is. 

About the Author

Ray Catudal

As Director of Healthcare Consulting, Ray is focused on CodeBaby’s healthcare specific customers and delivering on CodeBaby’s mission of customer centricity. With over 20 years of experience in medical devices, healthcare and technology, specifically: ehealth, health insurance, and software, Ray is a subject matter expert who contributes to industry articles, and speaks at trade shows and events.

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