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Revolutionizing the health insurance customer journey: Building a holistic patient experience

Revolutionizing the health insurance customer journey: Building a holistic patient experience

Patients are now expecting integrated, holistic experiences for their entire healthcare journey, driven by their voice and feedback. This means healthcare insurance providers and payers will need to provide access, guidance, and personalized reassurance throughout the journey. And the digital healthcare experience better be on point! Patient experience feedback plays a crucial role in helping providers, and payers make adjustments to the patient journey. Receiving feedback directly from patients provides business leaders with their customers’ pain points. The right data at the right moment can be a make-or-break moment in a healthcare situation. After all, a healthcare professional with the right information and patient data can better personalize care.

In today's rapidly evolving healthcare landscape, customer experience leaders face the challenge of understanding and improving the comprehensive customer journey. A key obstacle lies in the disjointed nature of the healthcare ecosystem, particularly the disconnect between the insurance/payer journey and the actual patient experience. Fragmented systems and incomplete patient data hinder insurers' ability to track and analyze the entire customer experience.

The key to delivering these experiences well comes down to understanding the customer journey thoroughly enough to be proactive and predictive around what patients will need. And to do that well, data access and visibility, providing the right options for patients at the right moment, and overcoming the real-life challenges around staffing and communication are essential.

While there are certainly real challenges faced by leaders trying to improve the patient journey, there are also strategies to overcome these hurdles, creating a more cohesive and less frustrating experience for patients.

Revolutionizing the health insurance customer journey: Building a holistic patient experience - Jeannie Walters quote

Modernize and streamline the measurement of customer experience data

To gain a comprehensive understanding of the customer journey, health insurance providers and healthcare professionals must adopt a unified solution to measure and analyze customer experience/feedback data across all interactions with customers, providers, and payers. This approach enables a holistic assessment of the customer journey, allowing for targeted improvements and enhanced customer satisfaction. By leveraging advanced analytics and data integration, insurers can identify pain points and uncover actionable insights to drive meaningful change.

The changes can include things like offering better digital and mobile options for scheduling appointments. “No show” and canceled appointments can cost a provider an average of $200 or more per missed appointment, which can lead to up to a $150 million loss, according to the National Library of Medicine.[1]

Maximize customer access with self-service options

Providing customers with self-service options empowers them and enhances their overall experience. Implementing self-service scheduling, automated appointment and follow-up reminders, self-service information, and tasks, and streamlined contactless intake and registration processes can significantly improve customer access and satisfaction. These initiatives reduce wait times, enhance convenience, and enable customers to have more control over their healthcare journey. Collecting and acting on feedback from self-service channels can point to what improvements will have the greatest impact.

Revolutionizing the health insurance customer journey: Building a holistic patient experience - Jeannie Walters quote

Improve the customer billing experience

One area of the healthcare journey that often causes frustration for patients is the billing process. Nearly 40% of patients report feeling confused about their medical bills. Health insurance companies can enhance the billing experience by enabling self-service, frictionless, and personalized interactions.[2] Offering intuitive online portals where customers can view and manage their bills, easily understand their coverage and claims, and receive personalized support when needed can alleviate billing-related stress and improve overall satisfaction.

Gathering client feedback

Having a voice of the customer (VOC) program empowers an organization to understand the customers’ needs and expectations. The organization may then use this data to proactively make changes to improve the customer journey.

To better understand the nuanced needs of healthcare plan members it serves on behalf of its client insurers and healthcare groups, Evolent Health added two brief post-call surveys for their customers.[3] They included both multiple-choice and open-ended, free-response questions. Using these voice of the customer insights, the healthcare services company uncovered new areas of focus for agent training and ongoing development, as well as product development suggestions Evolent shares with its healthcare clients. Evolent now incorporates their findings into a more positive employee experience by using positive feedback to encourage and recognize agents for superior service.

Revolutionizing the health insurance customer journey: Building a holistic patient experience - Jeannie Walters quote

Understand customer experience with real-time surveys

Customers provide valuable feedback via IVR and email surveys. This feedback helps health insurance providers gain a comprehensive understanding of the customer experience. By capturing insights from digital interactions, such as intent analysis, customer sentiment, and real-time feedback, insurers can identify pain points and tailor their services to meet customer expectations.

Health insurance companies can analyze customer interactions across various channels, including calls, emails, online chat, social media, apps, and website experiences. By harnessing the power of natural language processing and sentiment analysis, insurers can gain deeper insights into customer experiences, enabling them to proactively address issues and improve the overall journey for patients.

For example, a patient may be asked to complete an insurance claim themselves if their medical provider doesn’t work with insurance companies. Post-claim feedback from patients can help the insurance company understand their customers’ pain points. These types of steps can lead to better patient outcomes, and help patients feel more in control of their healthcare journey.

Empower agents with the right direction and human-machine collaboration

Different patients have different needs. Real-time voice of the customer (VOC) technology can guide and enable agents with suggestions, based on specific customer needs and situational context.

These powerful customer experience feedback tools provide performance tracking features that capture key metrics and indicators of agent performance. These tools enable organizations to monitor key performance indicators (KPIs) such as average handling time, customer satisfaction scores, and first-call resolution rates. By identifying areas for improvement and providing actionable feedback, these tools empower organizations to coach their workforce, optimize performance, and ultimately enhance the overall customer experience.

By leveraging omnichannel feedback and socializing the insights intelligently, the customer experience team and these tools collaborate to deliver an enhanced customer journey.

The future of healthcare, driven by the voice of the customer, is powered by AI and humans working together

The emergence of artificial intelligence (AI) presents immense opportunities for health insurance companies to revolutionize the customer journey and overcome the challenges they face.

AI-powered chatbots and virtual assistants can engage with customers in real-time, providing instant support and guidance throughout their journey. These intelligent agents can analyze customer data, understand intent, and deliver personalized recommendations, enabling a more tailored and proactive customer experience. By leveraging AI, health insurance companies can offer personalized interactions at scale, ensuring that customers receive the information and assistance they need when they need it.

Powerful AI algorithms can analyze vast amounts of customer data, including demographics, behaviors, and historical patterns, to identify trends and predict customer needs. By harnessing predictive analytics, health insurance companies can anticipate customer preferences, predict potential health risks, and tailor their services accordingly. This enables proactive interventions, personalized recommendations, and targeted offerings that enhance the overall customer journey. These predictive capabilities often will lead to better patient health outcomes and improved customer satisfaction.

Patients are seeking a holistic, simplified customer journey in the healthcare ecosystem.

Advanced tools, better data integration, and AI are poised to have a transformative impact on the healthcare customer journey, empowering health insurance companies to deliver personalized interactions, gain deeper customer insights, and mitigate risks. By embracing AI technologies and leveraging its capabilities, insurers, working with providers, can create a more seamless, engaging, and customer-centric experience. As AI continues to advance, it will undoubtedly play a pivotal role in shaping the future of the healthcare industry, enhancing the customer journey, and driving positive outcomes for both insurers and patients.

Embracing a customer-centric approach to the patient journey and staying at the forefront of technological advancements will be critical for customer experience leaders in the healthcare sector to thrive in the evolving landscape.

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[1] National Library of Medicine: Evaluating the Impact of Patient No-Shows on Service Quality (2020)
[2] HealthLeaders: Nearly 40% of Patients Find Medical Bills Confusing (2022)
[3] NICE: Evolent Health Case Study