UPMC Delivers Digital Customer Experience with a Human Touch

When the mother of a sick child was denied medication because of an error in her health care eligibility status, that error was quickly corrected through fast phone support—linking agents and updating her coverage information. In another instance, a customer support agent noticed a woman didn’t schedule a mammogram that was due and helped her schedule an appointment. That agent had been resolving another issue, but his proactive suggestion helped her get the care she needed—detecting a tumor early and possibly saving the woman’s life.

These are just two meaningful exchanges that have taken place between actual customers and customer service agents at the University of Pittsburgh Medical Center (UPMC) Health Plan. The commitment of UPMC to provide an exemplary customer experience is a major point of differentiation in the healthcare insurance industry, recognized by J.D. Power and Associates and the International Customer Management Institute (ICMI).

UPMC is the second largest health insurer in western Pennsylvania, and is among the country’s fastest-growing health insurance plans. With more than 2.2 million members, UPMC Health Plan is a global healthcare organization that spans 22 hospitals and a network of care sites across the world.

A strong focus on customer service is evident across the wide range of the UPMC Health Plan services, including dental, optical, Medicare, worker’s compensation and children’s and group health insurance. Through more than 240 representatives based in six different call centers, UPMC emphasizes building a personal customer connection to affect lives in a positive way. As a business, it aims to make effective and timely decisions. Genesys Customer Experience Platform has enhanced these processes, enabling UPMC to offer a state-of-the-art approach to customer experience, while remaining true to their deeply human, patient-focused philosophy.

Making the digital transformation

When UPMC Health Plan signed on with Genesys a few years ago, they faced clear challenges—the customer segment that was responsible for generating 25% of UPMC business absorbed 45% of contact center resources. The healthcare insurance provider needed to more easily and responsively contact patients to ensure they were receiving the care, services and guidance required. They also needed to replace rudimentary management that used spreadsheet processes to manage contact center staff. Most importantly, however, they wanted to embrace digital technologies that would go beyond multichannel interactions to forge a new level of customer engagement and continue to differentiate their business, services and level of customer experience.

Through omnichannel inbound and outbound phone, chat, and email support—and real-time actionable insights and analytics—UPMC can now ensure that they use timely resolutions to queries and proactive suggestions to fully support their members. The results of this shift to omnichannel customer experience already speak for themselves. Since implementing the Genesys omnichannel system, UPMC has added and improved both customer engagement and internal processes, including achieving over 95% rankings in first-contact resolution, agent channel knowledge and overall channel satisfaction.

They also saw the following benefits:
• Efficiency gains in servicing different member segments
• Daily, weekly and monthly reporting metrics for more intelligent and timely decision making
• Increased delivery of high-touch, proactive customer experience
• Instant customer feedback to support representative training and development
• Flexible routing strategies that connect members with the right resources and representatives
• Real-time contact center insights for day-to-day flexibility and planning
• The ability to resolve member issues within 20 to 30 minutes

Staying connected with members

Building on the UPMC commitment to exceptional customer service and providing the right information to members when it’s needed most, the Genesys platform ensures that when a member of the Life Medicare Advantage Program makes an inbound call, that member is routed automatically and connected to their assigned concierge. This connection helps form and uphold an efficient, effective and personal connection. The reverse is true—concierges proactively connect, or outbound, with their members to schedule appointments, highlight gaps in care, send notifications of benefits changes. The reverse is true—concierges proactively connect, or outbound, with their members to schedule appointments, highlight gaps in care, send notifications of benefits changes, among other tasks.

“Clearly, across all levels of our organization, we are a service-oriented business,” said Mary Beth Jenkins, Senior Vice President and Chief Operating Officer at UPMC Health Plan. “We’re committed to offering the best customer experience in the industry, and Genesys is a key enabler in helping ensure that success every step of the way.”

Maintaining customer experience and affecting lives

At the heart of UPMC Health Plan is a dedication to maintain a proactive customer experience and the ability to improve the lives of their customers. The UPMC Health Plan team happily shares stories of how omnichannel technology enabled them to make a real difference to their members. This is where the latest digital technology and customer care merges, benefiting the insurer and their members.

At UPMC Health Plan, the use of digital technology continues the evolve. After logging into the UPMC website, members can engage with a representative through live chat. The integrated system now automatically identifies the line of the business in which the member is enrolled, and directs them to the appropriately skilled concierge for help. Advanced chat support enables UPMC Health Plan to retain their high level of customer satisfaction while pushing metrics ever closer toward 100% first-contact resolution.

Making effective, timely decisions

Through the user-friendly interface of Genesys Omnichannel Desktop, UPMC Health Plan contact center managers can collate and understand both team and individual performances and make real-time decisions about how to allocate staff and resources, knowing that efficient service starts with an efficient contact center.

“Genesys software gives me good information on what my staff is doing, what state they are in right this moment, what type of call they’re on and type of interaction they’re in, and how long they have been conducting that particular interaction,” said Kurt Rutherford, UPMC contact center supervisor. “What’s more, it ensures that we get real-time views and statistics, which helps in real-time campaign creation, not to mention managing the day-to-day work, because now we can track things that change intra-day and intra-hour.”

“Quite simply, our driving value is service,” added Jenkins. “We believe in providing service excellence to all our stakeholders and customers. We do this with skilled and committed customer service representatives, stellar processes and the right technology in place to support it all.”

Hear UPMC discuss how they created a member-centric business, increased visibility and accessibility, and began proactively interacting with their members at our webinar available on demand, Delivering a Great Omnichannel Member Experience: Learn How from UPMC Health Plan. Read their complete customer success story here, UPMC Health Plan
Delivers High-Touch, Omnichannel Customer Experience.