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Medica Contact Center.pptx

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Medica Contact Center.pptx

  1. 1. © FIRSTSOURCE 2023 | CONFIDENTIAL | 1 Contact Center Overview
  2. 2. © FIRSTSOURCE 2023 | CONFIDENTIAL | 2 HealthcareContactCenterExperience Overall ~ 1500 Healthcare Contact Center Associates spread across US, India and Philippines handling 10 – 12 million annual interactions A Leading Regional Blue Plan Scope: Member and Provider Calls Delivery Location: US FTE Count: 150+ The largest Blue Plan in the state of Hawaii Scope: Provider calls for Eligibility, Benefits, and Claims Delivery Location: Cebu, Philippines FTE Count: 150+ Fortune 500 Multi-State Health Care Organization Scope: Medicaid Member and Provider Inbound Calls Delivery Location: US FTE Count: 475+ Leading provider of in-home and mobile health clinic solutions. Scope: Member Outbound Calls Delivery Location: US FTE Count: 150+ An American integrated managed care consortium, based in California Scope: Member Inbound and Outbound calls Delivery Location: US FTE Count: 120+ One of the Top 10 Health Plans Scope: Member and Provider Calls Delivery Location: US FTE Count: 300+
  3. 3. © FIRSTSOURCE 2023 | CONFIDENTIAL | 3 DeliveredOutcomesThatTrulyMatterToOurClients 15% - 20% AHT improvement using Conversational AI and ACW Automation > 20% deflection of calls using VIVR and Live Chat 20%-30% Cost reduction 5% - 10% increase in Quality and Compliance Improved Member Satisfaction and Agent Experience A Fortune 500 company • Medicaid and Market Place supported by ~300 agents with 100% work from home model • >2.9M Member inbound calls annually and Call Quality Score of >90% A leading non-profit HMO Blues Plan • Implemented a Decision Tree- based Tool • 80% - 90% improvement in Quality Performance for new hires • Overall reduction in ACHT by 25%, leading to higher agent utilization A leading East Coast Blue health plan • Meeting and exceeding MTM goals for last 9 months in a row • Exceeding Call Quality Performance for last 24 months in a row • Monthly Call Quality Goal >= 91% A Leading Blue Plan in the U.S. • Deployed resources to handle 90,000+ monthly call volumes meeting all the services levels and abandonment rate < 2% A Leading Blue plan in the Midwest • Across multiple LOBs, supported by 275+ agents handling > 600K Member and Provider inbound calls annually and a Call Quality Score of 88% Impact of Healthcare Contact Center services
  4. 4. © FIRSTSOURCE 2023 | CONFIDENTIAL | 4 3P Framework- SolutionGuidingPrinciples Contact Avoidance Baseline Contact Deflection Contact Handling Efficiency Transformation Driven Cost Savings • Reduce the overall call volume • Analyze and eliminate the need for customer to contact • Digital member and provider engagement and outreach • Introduce self-service channels • Direct customer to the preferred low-cost channels. • Automate the process • Maximize contact efficiency • Reduce efforts with Entity Extraction • Improve agent utilization • Next Best Action for Agents • Call Summary and Disposition • In-Call Automation • After Call Work (ACW) Automation • QA Automation TRANSFORMATION PROGRAM OPTIMIZED PREVENT PREDICT PROCESS (15%-20%) (5%-10%) (5%-10%) PREVENT PREDICT PROCESS
  5. 5. © FIRSTSOURCE 2023 | CONFIDENTIAL | 5 OurSpectrumofSolutionComponentsAcrosstheCustomerServiceValueChain Higher inflow of call volume Multiple applications to navigate Inadequate and incomplete case notes by the agents Lower Call quality leading to client dissatisfaction and penalties Yonyx Decision Tree First Assist Conversational AI - Agent Assist Industry Challenges Visual IVR with Live Chat First Customer Intelligence Celonis – Process Mining, EMS and Digital Twin Customer Service Operations Transition & Process Improvements
  6. 6. © Firstsource Solutions Limited | Confidential | www.firstsource.com Helping customers stay ahead of the curve through transformational technologies and capabilities Firstsource Solutions Limited, a RP-Sanjiv Goenka Group company, is a leading provider of transformational solutions and services spanning the customer lifecycle across Healthcare, Banking and Financial Services, Communications, Media and Technology and other industries. Our ‘Digital First, Digital Now’ approach helps organizations reinvent operations and reimagine business models, enabling them to deliver moments that matter and build competitive advantage. With an established presence in the US, the UK, India and the Philippines, we act as a trusted growth partner for over 100 leading global brands, including several Fortune 500 and FTSE 100 companies.

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