5.5 Health care

5.5 Health care

Company: Delta Dental Plan of Kentucky


The company manages dental plans for a broad range of client companies. In just a few months, Delta's customer service call center dramatically improved productivity by changing its call center performance metrics.


The company decided to revamp its use of existing technology, implement a stricter schedule-adherence policy, and introduce new incentive, quality, and team-building programs for its CSRs.

The first task for the call center's manager of customer service was to review how calls were handled. The 10-agent center takes about 30,000 calls monthly from plan providers, members, group administrators, and insurance brokers and agents. Initially, callers enter an interactive voice response unit where they can get automated information, such as the status of their claims. If they opt out of the automated system, the center's ACD routes the calls to CSRs.

One of the problems with the manner in which the center was handling calls was that CSRs were making decisions themselves as to how much time they needed to spend on after-call work. Calls were routed from the IVR to the CSR's phones, but each agent could decide when to answer these calls. The solution was to change CSR priorities.

A stricter schedule-adherence policy was introduced, requiring all CSRs to work on seven-and-a-half-hour shifts and be available 95% of that time. As well, a tiered structure for routing calls through the ACD was introduced.


Specific benefits that were realized include the following:

  • The average speed of answer dropped from more than 200 seconds to less than 20 seconds.

  • Call abandonment, previously more than 12%, virtually disappeared, to less than 2%.

  • Long-distance costs dropped by 20%, in spite of a 10% increase in call volume.

  • Fewer angry callers meant agents were less stressed, which has improved overall morale.

  • Formal performance-based programs for both individuals and teams were organized, with appropriate awards ranging from gift certificates and gift baskets to time off.

  • Call-handling and off-work time were scheduled more efficiently, and a formal call-quality program was established to ensure continuous top performance.

Company: Philips Oral Healthcare


Philips Oral Healthcare, Inc., formerly Optiva Corporation, located in Snoqualmie, Washington, manufactures Sonicare, a high-tech toothbrush that uses patented sonic technology, fluid dynamics, and electromechanical design to aid in dental care. The company sells its products in the United States through warehouse clubs, mass merchandisers, department stores, and other outlets as well as distributing its products in Canada, Europe, and Japan.


In the early days, Optiva's Customer Support Group consisted of 5 CSRs who received about 8,000 inbound calls per month. Its CRM solution was DOS-based, limited in functionality, and lacked reporting capabilities. From 1996 onward, Optiva experienced exponential growth and increased the number of CSRs to 52. A solution was required to manage customer relationships better and the large volume of calls and increased number of accounts contacting the center.


In 1997, Optiva implemented the Onyx Customer Care Solution, and in the following year, selected the Apropos Multimedia Interaction Management solution to provide the additional functionality needed and to integrate seamlessly with the existing Onyx database. The Apropos system increased the visibility of the center's activities, enhanced management's ability to extract data, and provided robust reporting capabilities.


The benefits of the combined vendor call-management software included the following:

  • Caller ID, intelligent routing, and screen pops of information

  • Access to pertinent caller data

  • Reduction in time of call handling by an average of 30 seconds

  • CTI capabilities that enable CSRs to call back customers who may have abandoned the multimedia queue

  • Robust reporting capabilities providing real-time information and business metrics to improve overall productivity and enhance the customer's experience

Company: University of Alabama Health Services Foundation, P.C.


The University of Alabama Health Services Foundation, P.C., is a nonprofit physician group practice that is a member of the University of Alabama at Birmingham (UAB) Health System. Since its beginning in 1973, the Health Services Foundation has grown to include almost 700 faculty, fellows, and physicians offering services in 33 specialties. These services are reinforced by the research and educational programs of UAB's Academic Health Center, resulting in patient care that is innovative, medically advanced, internationally renowned, and highly compassionate. The physicians of the Health Services Foundation are affiliated with UAB Hospital and the Kirklin Clinic at UAB, which houses most outpatient activities. The foundation formed the Management Services Organization in 1999 and consolidated operations and systems to manage activities related to revenue cycle, including billing and receivables management.


Approximately 30% of the foundation's small-balance patient accounts cost more to collect than the actual payment. With limited resources available for collection, these balances often were referred to collection agencies.


The foundation selected two products from Avaya: Proactive Contact Management and Self-Service Solutions, which were combined to provide a solution to the collections problem that gained additional revenue while freeing resources for other important tasks. With these solutions, the foundation created a virtual payment center designed to automate outgoing calls to patients via predictive dialing and immediately provide patients with an avenue for self-payment using interactive voice response.


The following benefits were achieved:

  • Maximization of the collection center's performance at the lowest cost

  • An additional $50,000 in revenue each month

  • Happier customers and better financial performance

  • Reduction by 27% in the number of agents needed to handle complex inquiries

  • All incoming calls regarding billing questions directed to the interactive voice response system first

  • The option for patients to quickly, independently, and confidentially manage their requests

Call Center Operation(c) Design, Operation, and Maintenance
Call Center Operation: Design, Operation, and Maintenance
ISBN: 155558277X
EAN: 2147483647
Year: 2003
Pages: 90
Authors: Duane Sharp
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