The Challenge:

When Managed Medicare members were at risk of losing drug coverage and needed reminders about their past due premiums, problems ensued for this health plan client

• In-house agent teams were overwhelmed by the volume of calls required
• Compliance regulations stipulated multiple reminder contacts within 10-day timeframe
• Loss of coverage could jeopardize chronic condition treatments and long-term outcomes
• Potential decrease in plan incentive payments for covering at-risk population

The Solution:

Main Statement: ResultsCX created a strong outbound soft collections team focused on helping at-risk Medicare members maintain drug coverage:

• Agents offered multiple options for helping members get current on premiums
• Long-tenured agent team approached each call with empathy, focused on ensuring the best possible client outcomes
• Team size ensured client could achieve compliance with contact timeliness requirements
• Offshore and subsequent nearshore staff approached helping members with strong sense of responsibility and commitment to effectivenes