Health Insurer Turns Hardware Replacement into a CRM Overhaul

When you've got a lemon, make lemonade. That's basically what Medical Mutual of Ohio did when the Cleveland-based health insurer decided it was time to ditch its 15-year old phone system.While installing a new private branch exchange (PBX) and automatic call distributor (ACD), the company took advantage of the new technology's advanced functionality to bring its two call centers up to award-winning status.

"We went from having the technical issue of buying a new phone system to fully exploiting new technology and adding a lot of value to the business," says Andy Balazs, vice president, enterprise technology advancement, infrastructure and operations, at Antares Management Solutions, Medical Mutual's IT subsidiary.

That business value includes: reducing average call wait time from more than 1 minute to less than 20 seconds; reducing percentage of callers who receive a busy signal from 7% to less than 1%; decreasing abandoned calls from 3% to 1%; and increasing overall customer service levels from 21% to 94%. And, 93% of inquiries are resolved on initial contact.

It all began three years ago when Medical Mutual embarked on a five-year call center initiative, purchasing a new PBX and ACD. The new hardware paved the way for the insurer to implement its customer relationship management (CRM) strategies, earning a "Best Use of Technology" Call Center Excellence Award this year from the International Quality & Productivity Center.

ROI analysis

In addition to a new communications network-from U.K.-based Avaya Inc.-Medical Mutual decided to add a new call recording system from Israel-based NICE Systems, computer telephony integration (CTI) also from Avaya, interactive voice response (IVR) with speech recognition, a call center workforce management system from Chicago-based Opus Group LLC, and an enhanced, homegrown Contact Online Reporting System, which the company calls CORS.

"The phone system we had previously was very outdated," says Sue Parsil, vice president of operations at Medical Mutual. "And as we looked to replace the phone system, we felt this was an opportunity for Medical Mutual to really use new technology to help us get closer to our customers and ultimately to help us reduce our costs."

And the company has done both.

A detailed ROI analysis shows that Medical Mutual's call center technology, which the company began implementing in 2002 at a total cost of $3 million, will yield a cumulative savings of $4.6 million by the end of 2007.

With an annual ROI of 25% and call center productivity improvement of 6.5% per seat, the investment paid for itself in 29 months.

Parsil describes the multi-year CRM project timeline.

2001: Medical Mutual launches its Web site, MedMutal.com. Customers can access benefit and claims information, e-mail customer service questions, and order ID cards through the site.

August 2002: The company installs Avaya's communication network and NICE recording equipment, which enables call center management to listen to live or recorded calls via the desktop.

January 2003: Medical Mutual implements CTI and an IVR application for its providers.

CTI enables customer service reps to receive customer information automatically on their screens-rather than requiring them to key in data such as the caller's name and identification number. Providers using the IVR application can determine member eligibility and benefits such as deductibles and co-pays without having to talk to a customer service rep.

July 2003: The insurer implements the Opus Group workforce productivity management tool, which it uses to forecast call volumes and schedule staff in its call centers-in Cleveland and Toledo-based on peak periods. The application also tracks service levels such as speed to answer a call, abandon rate, adherence to schedules, and call resolution time.

First half of 2004: Medical Mutual phases in its Contact Online Reporting system, which Parsil describes as the company's CRM "life line."

The browser-based system, which was developed by the insurer's IT subsidiary Antares, using Java and IBM Web-Sphere, is integrated with several legacy systems including billing, membership and claims.

CORS tracks all written, electronic and call center correspondence with providers, members and internal employees, replacing a rudimentary call tracking system.

Second half of 2004: The company integrates CORS with CTI. Callers are automatically identified as members or providers, and their ID numbers are used to retrieve information from Medical Mutual's legacy systems and display that data on the agent's desktop.

"CORS captures all information related to customer service inquiries," Balazs explains. "So if someone calls and says, 'My name is Mary Smith, and I talked to someone two weeks ago,' the system pops all the pertinent information-such as membership, benefits and group information-on the customer service rep's screen."

By saving time re-keying and looking up customer data in various systems, the CTI project alone resulted in a savings of 11 seconds per call, equating to more than $725,000 per year.

"When customer service reps have to type in a caller's demographics for 3 or 4 minutes, they can't really service the customer," Balazs notes.

"Now, the reps aren't keying in as much information as they used to. Instead, they're reading and thinking and adding valuable information during the call."

This year, the company has added speech recognition to its IVR application, and it's currently deploying claims status for providers via IVR.

IVR self-service for members will be available next year, enabling them to order network provider directories for their area.

In addition, Medical Mutual will expand its use of CTI to collect more customer information from its legacy systems, with the goal of providing 90% of what a CSR needs to answer a call in the initial screen pop.

After those functions are implemented, Medical Mutual management is considering launching Web chat and Web collaboration on its Web site.

Members can use Web chat to contact an agent while online with questions about coverage or claims, and Web collaboration will enable customer service reps to temporarily control a caller's computer screen to point to a specific page or information to help resolve their questions.

With so much accomplished since Medical Mutual began its initiative, Parsil says collaboration between operations and IT has been key.

"If you don't have that working relationship, teamwork and trust, you won't have a successful project." she says. "Very few players have changed since the project was implemented. The same people are still involved."

Antares' Balazs agrees. "This has been a good experience for everyone," he says. "At the end of the day, when I ask people about this project, they smile. They don't cringe. So we feel good about the impact we've had on the business. We feel good that we added value."

AT-A-GLANCE

Medical Mutual of Ohio

* Headquarters: Cleveland

* Founded: 1934

* Annual Revenue: $1.9 billion

* Customers: 3.5 million

* Group Customers: 31,000

* Employees: 2,400

* Business lines: Group and personal health insurance

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