A sit-down with a customer service rep
I recently convinced one of our customer advocates, Sarah, to leave her phone and talk with me about the Customer Contact Center (BCBSND's customer service center). Here's what she shared.
Me: Is there a main service philosophy that drives your team?
Sarah: There's a banner in our department that says, "Culture of Care," and that really sums it up. We make equally sure we're caring for customers (members and providers), each other, and the community.
Caring for customers means we try to get their issues resolved during the first call. In caring for each other, we try to make sure and celebrate the people around us—their milestones and lives. Caring for the community is just like it sounds. Last fall we raised money to fill backpacks for kids who might not otherwise get school supplies. We also get paid time away from our jobs to volunteer.
Me: Tell me about some of the standards your team tries to meet.
Sarah: We're measured on a lot of metrics. One I mentioned earlier is called "first-call resolution."
Our goal is to help the customer get a resolution the first time so they don't feel like they need to keep calling back about the same issue. It also allows us to be available for other callers. Our goal is to answer the phone with a live voice.
Sometimes we need to reach out to other BCBSND teams to solve a problem. But when that's the case, we set expectations and call the customer back when we get the answer.
We're also measured on quality. Our training includes how to really listen and allow the customer to maintain control of the call and then get to that resolution.
One thing we're not measured on is how many calls we take. That leaves us the flexibility to do what it takes to solve customers' problems.
Me: What can members do to decrease their wait times on the phone?
Sarah: That's not usually an issue (because of what I described earlier). However, the phones get really busy during open enrollment.
One thing I encourage people to do is take advantage of an option in our phone system that lets you enter your plan number and birthdate. That knocks off some time and allows you to get to the right area without being transferred around.
Second, I would tell members to have detailed information handy when you contact us.
Me: What is the number one thing you wish members knew about…
That it's a separate company from all the other BCBS plans. That's important for people to know. We're truly local, and we truly value customers.
- Their coverage
That insurance is about sharing costs between the member and the insurance company. It's similar to auto insurance.
Also, not everything is covered. If it were, insurance premiums would be outrageous.
- Contacting member services
I would encourage members to realize they have many options for contacting customer service—phone, a private message via Online Member Services, or if you feel you need a face-to-face conversation, there's help available at our district offices around the state.
Me: What are the most common calls?
Sarah: It's a pretty even split between checking to see if a specific service is covered and questions about a claim.
Me: What are your favorite BCBSND self-help tools?
Sarah: My personal favorites—the ones I use at home—are on our website.
Pharmacy Tools where you can get cost estimates and medication approval.
We also have an Online Member Services portal—where each individual on your plan can register and have access to 24/7 electronic contact with member services, check your claims in process, see where you are with co-insurance and give authorizations so others can inquire on your behalf.
And if you want to go green, you can sign up to get electronic EOBs rather than paper copies in the mail.
Me: Is there anything else you think it would be helpful for members to know about your team?
Sarah: I just want to reiterate how much we value customers and how much we want to get their issues resolved. The company, as a whole, is not here for any other reason than to help members.