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Challenge Higher Star Ratings are associated with a strong reputation and increased enrollment, retention, and revenues. But the truth is MA plans often find it challenging to achieve and maintain a high rating as Star Survey scores correlate to several dynamic and demanding factors: Plans must demonstrate strong performance across
The Challenge: In 2022, our MA clients faced a twofold challenge as they prepared for the Annual Enrollment Period (AEP): they had to swiftly expand their agent base while also adapting to new state laws requiring agents to sell within their state of residence to maintain their license. The ResultsCX
The Challenge: Immediately after a new Medicare plan year starts, this client experiences a surge in member inquiries about supplemental benefits and rewards, accompanied by challenges: Achieving Average Handle Time (AHT) target Maintaining call quality Achieving high customer satisfaction Shortcomings in knowledgebase that hampered agent effectiveness Inadequate outbound scripting mechanism
The Challenge: The largest Managed Medicare plan provider experienced significant support performance issues during volume spikes, despite a lengthy training program. The challenges included: Dropped calls, resulting in member frustration and incomplete issue resolution Low performance quality scores, impacting overall customer experience Excessive average handle time (AHT), affecting operational efficiency
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
The Challenge: When assessing the sales performance of support vendors, the largest Managed Medicare health plan wanted ResultsCX agents to significantly improve their sales rate. Key challenges were: A stronger focus on sales during the critical annual enrollment period was needed to increase sign-ups and meet enrollment targets. Existing client-provided
Challenge Medicare Advantage health plans understand the importance of driving higher CMS Star Survey Scores. 5-Star Survey scores correlate to: Millions of dollars in CMS performance incentives Stronger online reputation Enhanced standing for member plan choice among competitors Demonstrated excellence in quality and member experience Solution ResultsCX supports multiple Medicare
The Annual Enrollment Period comes around every year like clockwork for Medicare and Healthcare Marketplace coverage, as well as other health plans. This is a vitally important time of the year for every health insurance plan. The success or failure of an organization at maintaining enrollment and attracting new members
Challenge A leading Medicare Advantage health plan faced significant attrition. This made it challenging to staff healthcare claims work domestically and led to: Financial inaccuracies Performance quality issues Steep training costs Solution The ResultsCX team deployed a high-performing and fully engaged offshore team that was cost-effective and quality-focused: Instituted a
Challenge Medicare Advantage health plans understand the importance of driving higher CMS Star Survey Scores. 5-Star Survey scores correlate to: Millions of dollars in CMS performance incentives Stronger online reputation Enhanced standing for member plan choice among competitors Demonstrated excellence in quality and member experience Solution ResultsCX supports multiple Medicare