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Buckeye Health Plan (Centene Insurance)

900% Increase in Appointments Set and Substantial “Care Gap” Reduction

Buckeye Health Plan, part of Centene Insurance, is an Ohio-based Medicaid/Medicare health insurance provider, with a 150-seat member service center.  CCTS is presently working with the inbound reps, rolling out a customized version of our Superior Service program, called “World Class Member Care.”  This case study is about Buckeye’s small outbound group.  Prior to the start of the initiative, Buckeye leadership had created an outbound calling team, expecting to improve the company’s overall quality scores.  Having a dedicated outreach team was one big way to show Buckeye’s care for its members, checking in with them, making sure they are doing well, and setting up appointments where needed (e.g. if a member missed an Annual Well Visit, the team would reach out and offer to reschedule the appointment for the member).  Missing these required visits causes a “Care Gap,” which reflects badly on the provider and its overall quality.  The goal for the CCTS training was to increase the amount of appointments set by the team, thereby reducing Care Gaps and increasing quality scores.

Unique Challenge

Most of these calls went out to Medicaid members.  Although the agents (Advisors) were happy to offer appointments when needed, they were having a difficult time connecting with the member and few said “Yes” to the offered appointment.  Some members did not know that Buckeye Health Plan was their insurance provider.  Others did not feel like talking to the Advisor.  Others told the Advisors they would set their own doctor’s appointments, but usually did not.

Training Provided by Call Center Training Solutions

CCTS pulled skills from both its Telephone Sales Mastery Outbound and Superior Service courses to create an outbound course for the Advisors, called “The Member Connection: Proactive Service workshop.  Training was broken up over four days.

  • Training’s Big Idea:  Embrace and “love on” Members, building trust, so they will let you help them take care of their health care issues and improve their health as a result.
  • The course provided new skills for the Call Opening, responding to Early-Call Objections, Rapport skills and Offering to set the new appointment for the member.
  • All Advisors were trained to be “bolder” when talking about the Member’s situation and recommending that they set the appointment up while on the call.
  • The big focus shifted from the appointment to the member’s health.  Taking the appointment generally meant taking care of their health.
  • Each day, Advisors would participate in the training during the morning hours.
  • In the afternoon, they went back on the phones to employ the new skills.
  • The CCTS instructor, along with the team’s supervisor, provided live floor-coaching during the afternoons.

End Results

Prior to the training, the Outbound team’s best month ever for appointments was 26.  In the first month after the training, the same group of Advisors set 230 appointments.  For at least eight months since the training, they have been able to achieve similar results.  The best part is that the Advisors are now connecting with Members on viturally every call.  If a Member is unhappy about anything health-related, the Advisor is much bolder in showing care and helping the member resolve the concern.  Appreciative members now welcome the Advisor’s suggestion to set the appointment (and eliminate the Care Gap).

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