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BlueCross BlueShield of South Carolina (BCBSSC) has one of the largest technology workforces in the state and provides health insurance and administrative services to more than 1.3 million people statewide. So when BCBSSC sought to address the unacceptable wait times providers were experiencing when trying to reach support representatives, they found their solution was only a click away. By implementing a voice-over-Internet-protocol (VoIP) solution, BCBSSC streamlined the call center service process and improved overall responsiveness to provider inquiries.

 The BCBSSC call center handles thousands of incoming phone calls per day and serves approximately 14,000 in-network providers and 45,000 other related users. With continued growth and the increasing complexity of insurance coverage in recent years, hospital and physician team members who relied on our call center for service often experienced up to 50-minute queue times in order to speak with a provider services representative (PSR). Admittedly, 50 minutes is a long time to wait, but it isn’t atypical for call queues in all call centers because of peak call volumes and the prohibitive cost of staffing for those peaks. In the hold queue, call-abandon rates in which callers discontinue the call before reaching a PSR were at their highest point.

 We understood that this situation required attention as we worked to address the service levels and needs of both PSRs and the providers. We were unwilling to accept it as status quo. We knew there were more efficient and effective ways to do business that would result in a better environment for our providers, patients and our own organization. Realizing that a portion of the inquiries we received were routine and straightforward, we felt that handling these issues through a self-help channel would eliminate the telephone logjam we were experiencing within our call center, sparing providers long waits in queue. The establishment of multiple service channels, some of which would allow providers to serve themselves, became an overarching goal for our organization.

 Our first step in creating a solution was to evaluate the communications options available to our organization. Through a detailed review of our self-service channel, we ensured that providers were able to serve themselves and resolve 50 to 60 percent of their routine inquiries within their first call through a speech-enabled voice response unit. We also tackled other ways to address the needs of our users. When providers call us, they hear a recorded message directing them to our Web site in an effort to get faster response to their inquiries. We encourage providers to use our self-help tool on the Web before calling our toll-free line. Those who can’t find the answers they seek have the option of sending a secure e-mail to us directly from the site. We respond to messages within 24 hours and often in as little time as four hours.

 Solution Objectives and Configuration

 Fewer than 4 percent of providers found the need to opt out of the Web experience. However, we wanted to see many more users taking advantage of the Web site. The valuable information on our My Insurance Manager Web site and the benefits of having more providers utilize it led us to consider a voice-over-Internet- protocol (VoIP) solution we ultimately branded STATchat. We believed that implementing Click-to-Talk from Global IP Solutions (GIPS) would offer providers the incentive needed to migrate to the Web and minimize any chance of failing to complete their self-service transactions.

 With Click-to-Talk, if providers who have logged onto the secure section of the Web site can’t find a resolution to their inquiry, clicking on the STATchat icon instantly connects them to a call center agent who can then engage in a voice conversation. This approach eliminates the need for the provider staff member to pick up the phone and call for help. In order to draw provider staff members to STATchat, we established a call-prioritization incentive. STATchat calls were given priority status in the call queue over those who called our toll-free line. This meant that their time in the queue was measured in seconds rather than minutes. We also positioned STATchat as a safety net for users of our Web site.

 Additionally, to increase caller and contact center efficiency, we took advantage of the programmable nature of the software. This allowed us to program Click-to-Talk buttons with routing information so that Web visitors would be directed automatically to the right agent based on the type of inquiry. Our primary objective was for STATchat to fuel our organization’s initiative to improve overall telephone service by getting more providers to self-help. After providers acclimated themselves with our Web site, they would in turn become loyal users of the portal, particularly after they grew confident that Click-to-Talk was there to initiate a voice interaction when the need arose.

 We ensured that providers were able to serve themselves and resolve 50 to 60 percent of their routine inquiries within their first call through a speech-enabled voice response unit.

 Shorter Wait, Better Service

 We clearly understood the evolution taking place within call centers and could no longer assume such an entity would thrive by only offering live phone service. Instead, to meet the ever-evolving needs of today’s service-oriented customer, and the constant need to be profitable, a center must be more accessible in more cost-effective ways than ever before. Since the new STATchat enhancement was introduced to our Web site in 2004, it has helped reduce the 50-minute on-hold time to about 12 seconds, and has eliminated the time-consuming, “Please press 1….” VRU selection process. This has allowed healthcare providers to better focus on their vital role of caring for their patients.

 Because STATchat calls enter our Inquiry Center via the Internet, neither our organization nor the provider incurs telephone toll charges. Also, the time it takes to complete a Click-to-Talk call is much shorter than the data entry time it takes a PSR to reply via e-mail. User feedback was extremely positive after the STATchat implementation. Due to this increased provider satisfaction, recent data show that the number of unique providers using STATchat increased from 223 in the first quarter of 2005, to 980 in the first quarter of 2007, while the total number of STATchat calls increased more than 313 percent in the same time frame—from 7,500 calls to more than 31,000.

 The associated cost for operating STATchat is substantially lower than a live-rep answering a toll-free line. STATchat can even beat an automated voice-response system because about 40 percent of the time, traditional telephone users opt out of the automated VRU systems, choosing to speak with a live PSR. By contrast, only 3 percent of online Web selfservice users opt out.

 We implemented STATchat to incentivize providers to hang up the telephone and log onto the Internet, hoping they would view STATchat as a safety net in case they had the urge to speak to a live agent. Theoretically, our total traditional call volume would decrease. We’re claiming victory with this initiative because, in fact, our total call volume has dropped by more than 300,000 calls per quarter.

David Boucher is assistant vice president, healthcare services,
BlueCross BlueShield of South Carolina.
Contact him at [email protected].