Healthcare payers are a bunch of know-it-alls. 

But, then again, there’s a lot to know. 

Despite a complicated journey through the healthcare community, it often falls on the insurance agent to gather information, provide insight, recommend solutions, and deliver a seamless customer experience. 

But faced with siloed data sources, departments, teams, and changes in compliance and regulations, it’s hard for payers to present the experience customers want consistently.

Let’s briefly point out a few of those massive data-producing sources: 

• Within the healthcare community, there are around 938,966 physicians with varying specialties.  
• A classic study found that a typical American patient can see up to 18.7 different healthcare providers during their lifetime. For patients over 65, the average hovers around 30 providers. 
• There are over 1,100 healthcare systems in the United States, operating hundreds of hospitals and clinics. And each network uses its own filing and reporting systems. 

On any given day, an agent must gather data from numerous sources and systems, check for compliance, and provide answers for customers who believe the rep should already know about them and their medical history. 

Don’t you wish a customer relationship management system (CRM) was customized to handle the entire course of the member’s journey from acquisition and onboarding to customer engagement and retention?

There is. 

Sales teams have been using Salesforce CRM to simplify the often complex and fast-paced process of managing large volumes of inventory, customers, contracts, invoicing, leads, and more. Now, health services and payers are discovering the benefits of using this automated CRM platform for collecting, organizing, and analyzing member data for easier access and better customer engagement. 

Here are five solutions an integrated CRM platform delivers for payers. 

 

1. Deliver Member-centric Services

Members want affordable, easy-to-access healthcare coverage so that they can visit their doctor. Payers want members to see their doctor to stay healthy and reduce costs. Technology plays an essential role in this relationship. 

Along with offering affordable care options, member-centric services are based mainly on providing information and services that matter to your customers: confirming coverage for services, simplifying provider selections, and engaging in personalized, proactive initiatives, such as engaging in individualized member communications, using AI technology to identify and then connect with high-risk members and sharing preventative healthcare tips, real-time recommendations for healthy lifestyle devices, etc. 

But to offer member-centric services, you need to know your members. The Salesforce CRM system offers a single view of member information. Everyone involved in the member’s healthcare journey can engage on the CRM platform and share data to supplement their profile. 

These initiatives obviously benefit your members, but it also empowers your agents to deliver personalized, immediate services when members need them most. 

 

2. Provide Immediate Support

Keep in mind your members have already been exposed to personalized customer experiences. The e-commerce industry works hard to build trust in their brands, and this personalized CX impacts other service industries like healthcare. 

In a recent data management and research study, Ribbon Health found that over half (66 percent) of their respondents said they would have more trust in their health plans if they were based on a centralized, accurate, and detailed source of truth. Respondents viewed this as a significant factor in improving the quality of their experience. 

“Health plans must get ahead of member concerns to ensure retention and better understand what provider information is important to them, what factors will lead to increased trust in the system, and what data they view as key to driving personalized and inclusive care,” health surveyors concluded. 

Their research supports the need for payers to build better member retention and engagement through improved provider data infrastructure. 

 

3. Leverage Cohort Analysis

The healthcare industry generates vast amounts of patient data. Studies show that the healthcare industry generates around 30 percent of the world’s data volume. 

But how can payers leverage this information to improve services? 

Equipped with platforms that support interoperability and implementing AI technology, healthcare’s ability to segment and analyze this data presents unprecedented opportunities to coordinate with healthcare service providers to identify gaps in care, target regions with high disease incidences and redirect resources, expand the reach for case studies and research, and explore ways to reduce costs with more efficiency. 

 

4. Develop Efficient Operations

A 360-degree view of data can help payers determine which systems simplify overall workflow, thus saving loads of time and money, and which processes need more tweaking. For example, ask yourself: 

• How much time do your agents spend collecting member information from multiple sources, printing it, and mailing it? 
• How much time do agents spend toggling between multiple systems for information?
• How does this impact the time a customer waits for answers?

Spending excessive time on routine tasks is likely impacting operations more than you think. Unfortunately, this is time your agents could be handling complicated customer cases that require personal attention. 

For Salesforce, automation is key to improving efficiency. But convenience can’t take precedence over security, so Salesforce built this CRM platform with secured access in mind. 

The platform includes features that automate workflows and filter tasks to those best equipped to manage them. It is also installed with global compliance, HIPAA, and other industry regulations and certifications.  

 

5. Connect Using Customer-Preferred Channels

People use different channels to communicate with each other. Payers can do the same. 

Whether customers prefer email, live chat, texting, or phone calls, an integrated CRM can quickly engage with members via their preferred channels and through a secure platform. 

“Patients bring their consumer expectations with them to healthcare,” Lauren Wallace, Editorial Lead at Salesforce, said. “They want compelling, personalized experiences online and streamlined access to care across any channel of interaction–in the form of patient portals virtual visits, online prescription ordering, click and collect, and more.” She added, “In short, that means it’s no longer enough for providers to merely transact with patients.” 

With a customer’s data easily within reach, agents can proactively share helpful health tips, send reminders for follow-up appointments, or share the status of a claim. If the customer has questions that seem more involved than a text message, a call button can easily connect the customer with a representative.

The more data your CRM system can consolidate and organize, the more it will support actionable, data-driven, customer-centric initiatives that positively impact operations efficiency, improve customer satisfaction, and empower your support teams to deliver accurate information and services that your customers need and trust.