WPS Insures Its Customers With Better Service Through Speech

Providing better service to maximize customer satisfaction and increase customer retention represents an imperative as much as an opportunity for the business success of every organization.  Many organizations will make operational changes, create retention-marketing programs and introduce new products in their effort to be proactive in insuring customer satisfaction and retention.  But how can they be sure that the changes, programs and new products are offering their customers what they need and want? 

This was the case with Wisconsin Physicians Service (WPS), one of Wisconsin's leading health care insurers and one of the few remaining 'not-for-profit' companies still in health insurance.  With nearly 115 million claims from all health insurance programs (private, Medicare and U.S. Department of Defense Tricare program) and over four million calls every year, WPS has defined its mission as providing "health and life insurance and benefit plan administration to customers with service and value considered by our customers to be the very best." 

WPS was looking to provide better service by improving the total customer experience.  Every day WPS customer service representatives are talking to customers about the issues that matter most: product and service feedback, spending patterns and competitive offerings.  WPS realized that they could improve customer service and pre-empt customer turnover by listening to their customers to effectively identify, understand and efficiently escalate customer issues. 

On one hand is the customer.  If they were able to identify those customers who showed a high risk of choosing different coverage and deal with that threat in real-time, the risk could be mitigated.   On the other hand is the agent.  WPS wanted to better monitor and understand certain agent behaviors, to be able to correlate them to customer reactions and decisions, and - consequently fine-tune their procedures, guidelines and adherence thereto by all of their agents.

But with over four million calls coming into the call center every year, WPS was faced with an overload of information.  And without tools to help, it was nearly impossible to extract insights from these customer interactions and glean that down to meaningful business information to understand the real issues at hand.

WPS had been operating in a traditional contact center environment, in which call recording was done strictly for compliance and legal purposes.  In this environment, only transactional information was available.  Transactional analytics can only reveal what happened.  It was impossible to gather customer inputs and obtain critical insights from a business standpoint.  WPS needed to understand why, and be able to gauge what is likely to happen with their customers.  

WPS was faced with the challenge of shifting the call center and enterprise-basic paradigm of thinking about call data as transaction-based data to leveraging it as business intelligence data.  They set up a testing environment to assist with this challenge.

"It really required a paradigm shift to start thinking about call data in terms of broader business intelligence.  For example, using speech technologies, such as word spotting, to obtain information about business process problems required some tests to determine how to best find the information," says Sharon Whitwam, vice president of member services at WPS.

After a formal request for a proposal process, WPS selected an integrated speech solution, from NICE Systems. The solution a portal that captures multimedia interactions, provides speech recognition technologies, including emotion detection, and is integrated into the capture and quality monitoring platform. 

Emotion detection is another speech technology that is critical for providing better customer service because it helps to identify a customer's true intent and therefore enables the company to pre-empt defection.  When a customer expresses dissatisfaction, the call is flagged and routed to a member of the management staff.  The issue is then reviewed, and the customer receives a call back, almost instantaneously.  This has resulted in unprecedented responsiveness and customer loyalty.  

For example, a customer contacted WPS to express concern over an upcoming premium increase.  The call came in after the premium-billing department's call hours, which aggravated the caller.  The upset caller voiced their concern.  Picking up on the heightened emotion, the system flagged the call and sent it to a quality assurance staff member who listened to the call and contacted management in the premium-billing department.  The relevant manager contacted this customer and offered several options for lowering the cost of their insurance.  This ability to detect the caller's emotion enabled WPS to transform an unhappy customer into a retained customer.

Since the integrated speech solution was implemented, WPS has extracted tremendous insight from their customer interactions and has seen an increase in agent quality ratings. They also have achieved quantified improvements in customer satisfaction. 

To receive direct customer feedback, WPS conducted a "soft skills" survey of customers who contacted the call center.  The survey was comprised of seven main questions:

Did our agent:

  1. Treat you with courtesy and professionalism?
  2. Listen to what you had to say?
  3. Provide clear/understandable answers?
  4. Provide accurate answers?
  5. Seem as knowledgeable as you thought they should be?
  6. Promptly answer your question or let you know when the issue would be resolved?
  7. Provide a high level of service overall?

The survey results were given to the customer service representatives.  This helped them better understand how they are perceived by customers and enabled them to improve performance in areas where they received low ratings.   When compared with the results from a previous survey, WPS has seen customer satisfaction in all categories increase from three percent to five percent.  The survey conducted after implementing the speech analytics solutions revealed that no category rated less than 97 percent in satisfaction.

"As a result of the survey data, we began a campaign of 'going the extra mile' for the customer.  We wanted to take away the hassle factor that insurance can create.  We wanted to be the insurance experts for our customers.  Through use of speech analytics combined with agent quality monitoring, we have been able to create this culture in our call center.  This has resulted in increased customer satisfaction and agent job satisfaction," says Whitwam.

Furthermore, beyond customer satisfaction, the integrated speech solution is providing WPS with insights gathered from the contact center to help the whole organization.

Whitwam elaborates, "In the past, information related to phone calls was strictly looked at as call center information and wasn't used as a springboard for making business decisions or for understanding from a strategic standpoint what was happening.  This solution offers us a whole new way to gather intelligence, make strategic decisions, and understand our business and our products better."

In one example, this speech solution is helping WPS mitigate appeals exposure.  Every customer has the right to appeal a denied claim in order to request payment.  By creating an appeals lexicon (or collection of words to search for), WPS is able to identify and focus on the calls associated with a particular medical procedure. WPS can understand, during the pre-certification call, what the agent is communicating to the client that may have lead to the appeal and then go back and re-train those agents on the proper protocol, reducing appeals exposure in the future.
The marketing department was also able to benefit from the solution.  WPS does annual mailings for a product segment that involves the senior population, which communicates benefits and premium rates changes for the coming year.  In the past there were issues with customers understanding the jargon in the mailing, what the information was, what WPS was trying to convey.  This year when they did the mailing, they built a table of key words and speech-analyzed the customer interactions that were generated into the call center as a result of the mailing.  They were able to find out what the issues were from a communication standpoint, and found them to be different from their initial assumptions.  The information gathered was timely and rich in insights that will be used to make upcoming mailings more successful.  

Additionally, for the direct sales area, it was very important for WPS to understand from a strategic standpoint what competitors were doing regarding product and pricing, and to get that information efficiently and quickly, so that they can make product design decisions.  With word spotting capabilities, WPS is able to gather that information.

"We've improved agent performance.  We've improved our call center's productivity.  We've been able to gather a lot of business intelligence to help us make key business decisions.  And it's delivering those results from this technology that helped us get there," said Whitwam.

In the future, WPS is "looking to further fine tune the use of speech technology to sift through and find the "critical few" that will make the difference in terms of business intelligence, retention, etc.,"  added Whitwam.

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