The nonprofit prescription provider finds relief with improved speech recognition and better outbound capabilities
Rx Outreach is the biggest nonprofit prescription medication assistance company in the United States. The company began in 2004 as a subsidiary of Express Scripts, and was spun off in 2010 as an independent organization. To date, it has provided more than 400 different prescription medications at deep discounts or no cost to more than 150,000 clients with restricted insurance coverage, no insurance, or who are underinsured.
Based in St. Louis, the company employs 40 to 50 call center agents who handle 60,000 to 70,000 calls per month. These customer representatives not only take prescription orders but must also verify financial information and adhere to government-mandated privacy and security regulations.
"Rx Outreach needed a communications infrastructure that would allow us to more effectively reach and respond to a population of clients that deserves—but sometimes feels that they do not get—exceptional customer care," says Jeff Clark, the company’s chief information officer.
Starting in 2013, the company began experiencing phone outages that were vexing not only to customers but agents as well. As a result, finding a platform that could scale and handle increased call volume during peak hours topped Rx Outreach's needs list.
Another major issue was misdirected calls. "One of the things that the company was concerned about was more effectively routing its callers through the IVR and get[ting] them to the right agent queue as quickly as possible," says Todd Schmeer, director of speech application services at VoltDelta, who oversaw Rx Outreach’s deployment of its Dialog IVR application in June 2014.
"There is nothing more important than a patient taking their medications on time," Clark says. "Their health and well-being depend on it. We sought a solution because we were having issues with our current provider related to stability in the IVR and consistent call delivery to our agents."
Delta Dialog's voice self-service solution, customized to meet Rx Outreach's needs, employs speech combined with a voice user interface design. Immediately after implementing the solution, Rx Outreach saw voice self-service automation increase to 32 percent from 20 percent to 25 percent, eventually accounting for 36 percent of calls every month.
"Immediately we experienced stability and the absence of the dropped call issues we had experienced previously," Clark says. "Agents reported that the system was easy to use and patients were able to get what they needed without disruption and having to call back. Happy agents also help patient satisfaction."
Speech recognition was another issue plaguing Rx Outreach’s contact center. When customers call into the company's contact center, they need to be prequalified for acceptance and have to provide personal information. However, the company’s previous speech recognition engine could not always process what was being said. VoltDelta’s IVR included a speech recognition solution that provided greater accuracy for the prescription provider.
"There were a number of pain points related to speech," Schmeer says. "The company was having a lot of trouble validating members, who were asked to provide date of birth, and qualifying members by asking what their income was. There was a lot of trouble with accuracy due to constrained grammars."
"Pharmacy is complex and requires identifying information before you can get to the data needed to process the patient's request," Clark explains. "Something as simple as [a] date of birth that doesn't translate well through speech recognition was causing problems and driving self-service down and call handling up. [After deployment, such] problem areas related to speech recognition … disappeared."
Rx Outreach also needed to ensure that when capturing client information, it adhered to federal regulations under the Health Insurance Portability and Accountability Act (HIPAA). In addition, since the company allowed clients to use credit cards for prescription orders, it needed to meet standards set by the Payment Card Industry Data Security Standard (PCI DSS).
Although VoltDelta routinely implemented PCI DSS solutions for companies, Schmeer says combining it with HIPAA made for a complicated process. "You'd be surprised to learn the number of different data methods that the IVR has to learn to interface with just back-end systems."
Rx Outreach also requested a new outbound/inbound system and deployed VoltDelta’s DeltaCast solution, which generates automated campaigns. Now Rx Outreach customers receive calls when their prescriptions are shipped or when they need to refill or renew prescriptions. The result is less inbound call volume and increased medication fulfillment.
DeltaCast uploads outbound campaigns; in Rx Outreach's case, there are five different campaigns on a daily basis. One popular outbound call lets subscribers know that their program enrollment is about to expire. Another tells enrollees when their prescription will be mailed. With DeltaCast, the process is straightforward, Schmeer says.