When Blue Cross Blue Shield of South Carolina wanted to streamline its call center operations to improve productivity, it did not re-invent the technological wheel. Instead, the Columbia, South Carolina-based insurer implemented state-of-the-art software to leverage its existing IT systems.The intuitive, single browser-based interface simplifies data gathering and interpretation for its more than 350 customer service representatives.

"We found it took a lot of time and money to adequately train customer service reps on how to access data from all our different systems," says Anne Castro, chief design architect at the South Carolina Blues plan. "It also took too much time for them to manipulate and interpret that data to respond to a customer inquiry."

An acknowledged insurance industry leader in innovative IT applications, the company has an award-winning Web site for providers, agents and employers and recently focused more attention on customer service improvements in its private business unit through its CSRs and call centers.

The largest health insurer in South Carolina and an independent licensee of Blue Cross Blue Shield Association, the company provides healthcare coverage for more than 1 million members in the state.

"With the volume of calls we receive, we knew a single, cohesive browser-based application would drastically cut CSR training time and expense, as well as improve customer service by answering questions in a shorter timeframe," Castro says.

The Blues plan's customer service reps field thousands of complex questions on everything from billing and claims status and processing, to eligibility requirements and health plan options.

In the past, when customers reached a CSR through a voice response unit (VRU), they repeated their account numbers several times in the process. As reps searched through the company's multiple screens for specific data, customer identification numbers had to be re-entered yet again.

Oftentimes customers were put on hold while CSRs took time to manipulate data from different sources to answer one question.

Although the South Carolina Blues plan has a single back-office processing system for all parts of its business, its data and customer information resides in a number of complex files that include customer information, benefit information, and inquiry tracking data. Therefore, customer service reps needed extensive education and unique knowledge on how to access the information from those multiple sources.

"We have always had strong business logic in place; we just needed to tap into it more efficiently," Castro explains. "The challenge was how to take that older, utilitarian technology and make it more user-friendly for our reps by way of a browser-based presentation layer."

Simplifying the process

As part of the company's eventual and total technological migration from back-end processing systems to the intuitive browser-based world, Castro says BCBSSC created and developed the Customer Service Desktop engine.

This new engine aggregates and automates data throughout the enterprise (benefits statements, claims information, plans, tour of benefits, etc.) and brings it to the CSR desktops in a browser-based interface.

To leverage existing systems and avoid a complete host-integration project, the engine was created with screen-scraping technology such as Miami-based ClientSoft Inc.'s WebPak as well as state-of-the-art tools contained in Cupertino, Calif.-based NetManage Inc.'s RUMBA Developer Edition and RUMBA Web-to-host technology platform.

The NetManage RUMBA products were recently added because they integrate the insurer's mainframe systems with its intuitive browser-based presentation systems and automate the interactions between mainframe and other applications in a single, cohesive browser-based application.

"This technology serves as the communication link between the information stored in our legacy systems and an intuitive browser-based interface that consolidates, manipulates and interprets data for our CSRs onto a readable, simplified desktop display," Castro says.

BCBSSC selected NetManage Inc.'s custom host access products based on the insurer's detailed capacity and security requirements, she adds. The products also use flexible object technology and support standard development environments such as VBScript and JavaScript.

Training time reduced

The desktop engine gathers information from multiple back-office applications. For example, it can connect with the voice-response unit system to receive customer account information before the customer connects with a CSR-navigating the mainframe application and populating account information on behalf of CSR. Therefore, when the customer is connected to the CSR, redundant input is eliminated.

If the CSR inputs other specific customer data, the system will interact and request to pull up documents from the Web servers, claims data from a mainframe application or other information from other sources.

As a result, Castro says CSR training time has been cut by 50%, CSRs can access key customer data in five frames or less and within 10 seconds, and errors have been reduced by eliminating redundant input.

"This has also improved the quality of our contact logging and data collection," Castro says. "Standardized, thorough data collection helps us add enhancements to the system as well as measure employee productivity and performance."

A Larger Solution

Although Castro will not say how much BSBCSC spent on the technology or the amount of money saved, she says the new CRM engine has reached the company's projected ROI and achieved considerable cost savings.

"Our productivity continues to rise at the same curve as our business has grown, which is a phenomenal reflection of savings," she says.

Castro also notes that the CSR desktop improvements are a major component of the company's customer relationship management (CRM) solution, an ongoing, overall philosophy to provide the best tools for customers to answer their questions faster.

The strategy centers on providing technological advancements and capabilities for customers to be helped through multiple channels that include voice response units, the Web site, and customer service representatives. The CRM solution is "a multi-pronged, long-range technical attack" to eventually reach the goal of 100% self-service for BCBSSC customers in the future.

"We won't be able to reach that goal overnight or with one project," Castro says. "In the meantime, we have set a goal of resolving 100% of customer questions or problems at their first point of contact, be it a VRU, the Web site or our CSRs using their improved desktop systems."

Tina Tapas is a freelance writer based in Prospect Heights, Ill.

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