Aetna Customers Talk Back

One of the most frustrating aspects of life for American consumers in the 21st Century is trying to complete a transaction or obtain information from a company over the telephone.Whether it's ordering a new pair of shoes, checking the status of a utility bill, or seeking help with a computer problem, the experience can be both exasperating and mind numbing.

Often, consumers have to endure a lengthy and time-consuming menu of options that invariably omits the one item that they called about. Then there's the irritation of wanting to talk to a human being-a customer service representative-but not being given that option. Or the humiliation of being asked to give an ID number or password over and over during a single call.

All of these mounting annoyances can turn consumers off to your company.

In fact, a poll conducted in 2003 by Harris Interactive for Nuance Communications Inc., a Burlington, Mass.-based provided of voice-automation solutions, found that 88% of consumers report the customer service they receive is either influential or very influential in their perception of a company.

Telephone automated response systems contribute to that perception. The Harris research reveals that 61% of consumers try to use automated phone systems, but only 11% report success in those endeavors, and another 37% immediately press zero to talk with a live service rep because they don't believe the automated system can help them.

It's not surprising, therefore, that some companies are finally recognizing that an automated telephone system-if carefully designed and managed-is a good way to keep customers.

Aetna Steps Up

One of those companies is Aetna. In 2003, the Hartford, Conn.-based heath insurer introduced what it calls, "Aetna Voice Advantage," a voice automated telephone response system designed to better meet the needs of its customers.

The system accepts calls from both members and health care providers, and uses speech technology provided by Nuance. Although the system is voice automated, callers have the option of interacting through touch-tone. They can, for example, enter their member or provider IDs either by voice or by telephone keypad. And, at any time during the transaction, they have the option of switching from the automated system to talk directly with a customer service representative.

The company has found that automated speech works better than telephone touch-tone responses in a number of ways, according to Dottie Verkade, head of Aetna's service innovations.

For example, callers can simply state their reason for calling rather than having to wait for a menu of selections. And when menus are offered, they are personalized to fit each Aetna member's own profile and level of service. They are asked, for instance, whether they want to discuss their medical or dental plan-only if they have both plans with Aetna.

Automated speech also allows for more variables of responses especially since the Aetna program has been tailored to accept a wide variety of categories. For example, when giving a birth date to the system, the caller can say: January first, January one, or oh-one. And touch-tone responses are limited to numbers, the pound sign, and the star sign.

"With a speech system," Verkade says, "you can make the options much more intuitive for members."

To meet the needs of health providers using the voice automated system, Aetna uses language that is familiar to them and also provides a fax-back function.

Many provider inquiries deal with the issue of a patient's eligibility. So Aetna's voice system provides them with the choice of receiving eligibility status directly through the system or by fax. The system typically sends out 6,000 to 10,000 automated faxes per day, which can then be placed directly into a patient's file. "We've had tremendous response to the fax-back feature," reports Verkade.

Improving Service

Even though many automated phone systems can be a source of frustration for callers, research indicates that consumers are willing to use self-service technology.

According to the Harris survey, 92% of consumers say they are comfortable handling at least one customer-service task on their own, and 70% say they are comfortable handling a variety on their own.

And, Aetna reports that its automated voice system is actually improving customers' use of self-service. For instance, the system handled more than 50 million calls in 2004, and 15% of those calls were completed in the Aetna Voice Advantage system, without the need to talk with a customer service rep. Previously, fewer than 3% of Aetna members and health care providers used telephone self-service.

Even live customer service, although often preferred by customers, can be annoying-and automation can help alleviate that problem, according to Harris.

For instance, the Harris poll found that one-third of all customers complain they have encountered unpleasant service reps on the phone-and almost three in four report dissatisfaction because it takes too long to speak with someone.

"With automation handling more of the routine, information-gathering calls, agents are able to focus on more complex calls without the pressure to move on so quickly," the report suggests. "Good automation routes callers more quickly to the right agent, reducing the frustration on the caller's end."

A Continuous Process

Aetna Voice Advantage has helped its customer service reps provide better service, according to Verkade. Because callers who want only routine information such as the status of a claim can obtain that information quickly through the automated system, fewer of those calls are routed to customer service. "It allows our reps to spend their time on more complicated calls," she says.

Verkade also explains when callers choose to leave Aetna Voice Advantage and speak directly with a customer service rep, the rep immediately knows who the caller is, since customer data transfers from the phone system directly to the rep's desktop application.

"The benefit of this integration is that the caller doesn't have to repeat identifying information, and the customer service representative knows what transactions have occurred in Aetna Voice Advantage prior to opting out," she says.

Even with the benefits that already have accrued for both the insurer and users of the voice-automated response system, Aetna is looking for ways to make the system more responsive and easier to use. It does this, in part, by conducting user interviews and holding focus groups.

"Feedback is a continuing process," says Verkade. "We've done a tremendous amount of work to understand and improve how the member interacts with the system."

The key to ease of use is using language that users can easily comprehend, she says. "We want to understand where they're puzzled and what they'd like to do-and we're building a vocabulary based on what they say."

For instance, the system recognizes there are as many as 10 different ways for a caller to ask for a customer service rep. And, because many people don't remember a specific day they visited a doctor, the system gives them ranges of dates, rather than requiring a precise one.

Aetna wants to make the system as responsive and easy to use as possible, and that sometimes involves being able to handle more than one answer from a caller at a time. Even that is within the realm of possibility, according to Verkade.

"The challenge is that conversation is dynamic and infinite, and we try to make enhancements with that in mind," she says. "There are tremendous strides in the technology, where the speech system could understand compound answers before. We'll be implementing [those improvements] sometime in 2006."

In mid-December, Aetna held four "innovation workshops" with customers, to learn what their ideal experience would be when they call an insurance company.

The feedback the company receives from those workshops will be used to enhance the system. In addition, Aetna has set up a Web site for health care providers, enabling them to offer suggestions on how the system can be tweaked or improved.

Two pieces of feedback in particular have helped the company improve the fax-back service offered through Aetna Voice Advantage. First, health care providers told Aetna they needed more details on the claim payment faxes.

"In response," says Verkade, "we added more than 10 new pieces of claim payment details on these faxes, including the amount the patient is responsible for paying."

The same information can be given by voice through Aetna Voice Advantage should the caller prefer that method to fax.

Second, a focus group of health care professionals in Houston requested that Aetna's logo, rather than only the company name, be printed on fax-backs. The logo validates the document as official in a way that the name alone does not, she explains. "This is important to them when they are coordinating benefits with other insurance carriers. So we are in the process of adding the Aetna logo to those faxes."

Louis Berney is a freelance writer based in Baltimore.

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