Health Care

The Prescription for Patient and Client Wellbeing and Regulatory Compliance

With changes on the horizon due to industry reform, the health care industry faces increasing competition and regulation. At the same time, the cost of providing customer service to patients and clients is on the rise. Health care call centers must keep current clients enrolled and gain new ones while watching the bottom line and maintaining regulatory compliance. These pressures all point to the needs for both operational efficiency and service excellence in the health care call center.

NICE can help:

  • Improve patient and client satisfaction and retention
  • Respond effectively to client inquiries about billing, plan coverage and other issues
  • Comply with regulations and safeguard medical records and other sensitive information
  • Improve sales and collections performance

NICE provides a broad offering of business solutions targeted to address critical operational and strategic needs in the health care call center like first contact resolution (FCR), average handle time (AHT), churn reduction and collections effectiveness.

Improve Satisfaction

In a highly competitive market, customer satisfaction is a key driver in ensuring retention and achieving long-term growth. Many health care call centers serve two customers, the patients that utilize health services and the clients—doctors, labs, clinics, pharmacies and hospitals—that provide them. Understanding the expectations of these diverse health care constituents and ensuring employees consistently meet those expectations at the Decisive Moment™ of customer interactions enables the call center to keep all customers happy. A strong focus on customer satisfaction positions a business to compete on service, not on price, improving revenue performance and preventing profit margin erosion.

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NICE enables health care call centers to gain and apply insights from customer interactions with products like:

  • Churn Reduction
  • Customer Experience
  • Customer Feedback
  • Quality Optimization
  • Call Center Quality Monitoring
  • Real-Time Guidance

Respond Effectively

Customers expect prompt and accurate responses when they contact their health care provider with questions about their bills, plan coverage and other issues. Responding effectively requires that health care call centers have adequate staff in place with the right skills and knowledge performing their duties quickly and capably. Fully capturing the interaction with customers also ensures that correct information is provided at the Decisive Moment™ of the interaction and assists in researching and resolving any disputes.

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To maximize employee productivity and promote a satisfying customer experience, NICE helps health care call centers accurately align staff resources with customer demands and ensure prompt and consistent handling of customer inquiries including:

  • First Contact Resolution
  • Average Handle Time Optimization
  • Quality Optimization
  • Interaction Recording
  • Workforce Management
  • Interaction Analytics
  • Real-Time Guidance

Comply with Regulations

Health care providers face a growing number of regulations from multiple sources. As a result, customer interactions occurring in the call center must be documented to ensure compliance, pass audits and resolve possible allegations of impropriety. Patient medical records and other sensitive information must also be protected from accidental or wrongful disclosure arising from external as well as internal threats.

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Mitigate the business risks of regulatory non-compliance by recording calls, protecting sensitive information and making sure employees follow established processes and procedures. NICE helps health care call centers capture and store customer interactions, monitor and manage employee performance, and safeguard patient and client information with:

  • Compliance Recording
  • Data Security
  • Call Archiving
  • Call Center Quality Monitoring
  • Interaction Analytics
  • Branch Office Solutions