Virtual assistants bridge the gap between self-service engagement and call centers
As a healthcare payer you need members and providers to interact with your organization in order to process claims, authorizations, and other requests. And knowing that engagement is the key to customer satisfaction, improved clinical outcomes, and reduced call center costs you’ve likely already established strategies that encourage members and providers to access and submit information through your digital platform. Solutions such as portals and a mobile app can field many requests. But traditionally, when they can’t find what they’re looking for or have needed something more interactive than a self-service option, members and providers have had no choice but to reach out to your customer service team.
Your call center is not the most efficient place to manage routine interactions. Overuse has a negative impact on your members and providers, resulting in increased wait times and abandonment rates, and a negative impact on your bottom line as call center administrative costs outpace ROI.
Seeing this need and following user experience best practices across consumer-driven industries, healthcare technology has significantly and rapidly evolved. The result: virtual assistants that are capable of bridging the gap between self-service engagement and payer call centers.
What virtual assistants do is simple: they automatically respond to common inquiries and requests, seamlessly, in a secure environment. When a member or provider initiates an interaction via their smart device, the virtual assistant responds in kind, either by text or voice. After collecting some basic information, the virtual assistant is able to answer the question(s) posed or guide the member or provider directly to targeted information on the portal. If an interaction requires escalation, the virtual assistant is able to transfer the member or provider to a live agent and share the transaction record to ensure a seamless handoff.
How virtual assistants operate is more complex: using artificial intelligence (AI), natural language processing, and machine learning they are programmed to answer common questions and requests conversationally. Learning from past experiences, virtual assistants ensure that each ensuing interaction is more intelligent and intuitive than the last: including recognizing tone and regional dialects and responding to a growing list of topics that can be addressed fully in this environment.
With an understanding of how they work, let’s talk about how virtual assistants help payers achieve member and provider engagement goals.
Virtual assistants can make engagement more efficient for payers
Call centers are a necessary part of your operation as there are some interactions that are better served by a live rep. Keyword–some. But if you’re like most payers, then your call center is over-utilized by members and providers to handle routine requests–calls about lost ID cards, deductibles, EOBs, authorizations, and claim status. And while you can do things to help your reps be more efficient, you aren’t solving the real issue, call volumes.
Realistically, the vast majority of interactions currently handled by your call center can and should be handled by your engagement platform instead. But members and providers don’t always know where to find something they are looking for or need to ask a more complex question. Virtual assistants provide that extra layer of interaction.
And while virtual assistants intuitively communicate with members and providers, your call center is free to handle complicated questions, urgent requests, and to care for populations better served by live communication.
Virtual assistants can make it easy for members and providers to engage with you
The more restrictive and complicated it is for members and providers to locate information or make submissions to you, the more likely they are to contact your call center instead.
Virtual assistants simplify this process by giving immediate answers and directing them to targeted information on the portal–anytime, anywhere. And because not all questions come up during standard business hours, this means that members and providers have access to assistance 24 hours a day, which 64% of people surveyed noted as the most valuable element of virtual assistants.
Virtual assistants can enable engagement across devices
Your engagement solutions are only as good as they are accessible. If you require members and providers to jump through hoops–using complicated or outdated technologies to facilitate interactions–they won’t.
Virtual assistants solve this problem by providing a low-effort solution for members and providers that meets them where they already are, on their smart devices.
Virtual assistants can give payers actionable insights
AI powers intelligent and intuitive member and provider interactions now, while collecting data to prepare for what comes next. Virtual assistants connect the dots for payers, sharing insights into member and provider engagement behaviors and motivations.
And your members and providers are learning and evolving too, they are learning that: 1) they can reach out to the virtual assistant first for targeted and accurate responses, and 2) where on your platform they can access or submit information the next time they need to.
A cloud-based, HIPAA-compliant solution can reduce the risk of new tech
Virtual assistant technology is relatively new in the healthcare engagement space, and that can come with inherent risks. Will you have to invest in your infrastructure? Will it be HIPAA compliant?
When shopping for a virtual assistant vendor these are especially important questions, as not all solutions are built equally. The differentiator is a cloud-based solution that integrates into your existing platform securely.
Learn more about how virtual assistants are changing member and provider engagement
Engaged members and providers result in improved clinical outcomes—and, when that engagement takes place on your platform, payers experience reduced call center costs.
But the business of engagement has become increasingly complex as member and provider expectations evolve. In a recent survey by Salesforce, 58% of those polled said that emerging technologies have changed their expectations of companies. Virtual assistants help healthcare payers stay ahead of evolving consumer expectations.