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Payor and PBM
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With consumers taking charge of their healthcare decisions, payors, insurance companies and pharmacy benefit managers (PBMs) must work to better understand them and consider their needs throughout their lifecycle. At Convergys, we understand the healthcare customer. They desire knowledgeable healthcare call center employees who can address their needs on first contact, access information quickly, and treat them as valued customers.

Convergys provides insurance companies customer service and outsourcing solutions that enhance retention and drive results.

Benefits of the Convergys healthcare contact centers:

From acquisition to retention, healthcare call center solutions help clients leverage member viewpoints to develop a memorable and cost-effective customer experience.

  • Acquisition: Maximize telesales while making a good first impression through proper staffing, knowledgeable and effective agents, and appropriate use of technology.
  • Member and Provider Service: Delight customers−who have increasingly high expectations−yet still control, or reduce, costs.
  • Retention and Loyalty: Understand the causes of member defection and take steps to reduce it.

Our Portfolio of Healthcare Call Center Solutions:

Thought Leadership Series Thought Leadership Series

Issue #1: Targeting and Securing Your Customers
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Our Portfolio of Solutions Includes

Quality Agent-Assisted, Sales/Enrollment

Growing membership means shifting from a reactive to a proactive sales culture - and Convergys can help. Whether it's providing cost-effective, flexible capacity during open enrollment, or ongoing support through our high performance sales and retention programs, Convergys drives acquisition success.

  • Effective licensed agents trained in consultative selling
  • Specific expertise in Medicare enrollment and senior service
  • Dedicated save desk capabilities to improve retention

Measurable Results: For a leading PBM, our healthcare call centers enrolled over 440,000 members in one season with conversion rates reaching nearly 40 percent.

Acquisition Services - Build Membership

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Meets Medicare Growth Goals with Quality

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Quality Agent-Assisted, Member and Provider Service

Looking to capture quick savings by targeting specific call types and programs for outsourcing? Convergys insurance companies customer service solutions can help. With 15 years of healthcare experience we bring unmatched expertise to reduce costs while driving improvements in customer satisfaction.

  • Agent hiring, training, motivation and supervision driven by customer satisfaction
  • U.S. and near-shore, as well as bilingual and home agent programs, for flexible capacity
  • Back Office solutions that combine integrated document management, data entry and transaction processing with workflow management

Measurable Results: For a leading health insurer, healthcare contact center outsourcing reduced training time by 33 percent saving them nearly $10.5 million.

Member and Provider Service - Reduce the Cost of Superior Customer Service

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Provides Seamless Service with Home Agent Solution

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Relationship Management Technologies

Need to contain costs without decreasing customer satisfaction? Our healthcare contact center outsourcing solutions include self-service automation and assisted service optimization technologies, which are available licensed or on-demand to meet your needs.

  • Self-Service to Live Agent - Suite of intelligent products – self-service, notification and call routing – that enables multichannel member interaction
  • Convergys Dynamic Decisioning Solution - Real-time enterprise policy management solution with upsell/cross-sell, retention and cost-containment capabilities across channels
  • Intervoice Voice Portal - Power of speech and web-based standards provides a personalized experience for end-users

Measurable Results: For a healthcare client, our healthcare call centers reduced agent-handled prescription status calls more than 15 percent with automated messaging – saving $4.5 million.

Using Multichannel Automation to enhance member and provider relationships

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Triples containment rate in automated self-service IVR while improving customer experience

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Customer Analytics and Consulting

How do you build loyalty in an industry where more than two-thirds of consumers consider all the players “the same”? By differentiating yourself through outstanding customer service – and Convergys healthcare contact center outsourcing can help.

  • Customer experience mapping to ensure consistently positive service regardless of contact channel
  • Analytical tools to uncover ways to gain efficiency, reduce costs, and deflect or prevent calls
  • Formal satisfaction measurement and benchmark to guide and evaluate service and cost reduction initiatives

Measurable Results: For a nation-wide payor, the Convergys insurance company outsourcing solution saved an estimated $1.4 million savings annually by preventing callbacks with data uncovered in Point-of-Service Evaluations (POSE).

Designing a Member Experience Strategy to Bridge the Customer/Company Divide

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Retention Services - Take Steps to Reduce Member Defection

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Convergys Customer Satisfaction and Loyalty Services

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