Customer communication benefits for health insurers (and members)

Consider this scenario:

Mary signed up for health insurance coverage through her work but she rarely used her benefits. Other than annual enrollment time, her insurance company made no attempt to engage Mary in any conversation or relationship. Why should they? That just costs money the company could use to pay claims of members that really need the benefits.

One night, appendicitis sent Mary to the hospital for unexpected surgery. Recovering at home, she started receiving mail. Bills from her doctor, the hospital, labs, surgeons, anesthesiologists, and radiology arrived quickly following treatment. Most confusing of all, her health insurer sent several documents that seemed to indicate Mary owed money for deductibles, out of network providers, and exceeded coverage limits. The Explanation of Benefits forms said to call Customer Care if she had questions. So she did.

After multiple transfers and over an hour on the phone Mary got her questions answered. The time spent handling the call was expensive for the insurer though. It turned out Mary didn’t need to do anything but wait for more updated information. Her first personal interaction with the insurance company left Mary needlessly stressed and embarrassed for not understanding how it worked.

Crystal clear messaging is paramount to healthy customer relationships. Claim-related documents typically arrive at an already stressful period for the insured because of health concerns, time away from work, or out of pocket expenses. Members don’t deal with insurance issues very often. Incomprehensible documents or an excess of jargon can be a flashpoint if there is no easy way to get more information.

Accessibility, information, relevance

A key factor in the strength of customer relationships is the nature of communications beforethe generation of documents typically responsible for prompting questions or concerns. If little or no connection with members exists, the relationship is weak. Any confusion or perceived problems can spawn distinctly negative conversations.

Using some information they already had about Mary, her health insurer could have sent her some informational material or links to online content about how claims are submitted and paid, explained what happens when someone requires a hospital visit, how to avoid out-of-network charges, etc. They might have suggested some health tips, introduced her to the Ask-a-Nurse program, or explained some of the benefits she wasn’t using.

Other customers might receive information more relevant to them. A health insurer might introduce retirees to senior fitness programs offered in their area or tell them about mail order pharmacies. They might remind parents with school age children to make sports physical appointments or help them accumulate immunization records before school starts, etc.

All these “non-essential” communications help create a foundational relationship while establishing loyalty and tolerance for issues that might occur later. Educational content sets reasonable customer expectations. Documents can direct members to online or automated telephone self-help resources. These are much less expensive than customer service representatives handling one caller at a time.

The documents an insurer produces can either enhance or degrade the connections. Delivering periodic informational content relevant to each member is easily accomplished with modern customer communications management software. Contemplating relationships from the customer’s viewpoint is an exercise worthy of periodic examination. Adjusting communications accordingly is a strategy beneficial to both parties.

COVID-19 update

The spread of COVID-19 continues to evolve and in this context, we wish to inform you that Xpertdoc is closely monitoring the situation and would like to inform you of the measures taken by our team to support its employees, customers and partners.

We do not foresee any impact on the delivery of our services and want to assure our customers that we are executing our continuity plans in order to ensure that our customers continue to receive our services without jeopardizing the safety and security of our personnel.

In accordance with the recommendations of government authorities, here are some of the measures being taken by Xpertdoc:

Remote work for all employees
Arrangements have already been made and we have requested that all our employees work from home. Our continuity plan includes a full deployment of remote work arrangements to ensure uninterrupted service to our clients and partners.

Hosting and cloud services
We have been assured by our suppliers that there are no known impacts to these services, and we are confident that we are able to effectively manage the delivery of our cloud services to all our customers.

We have cancelled all business travel until further notice for all our employees. If employees have or will travel for personnel reasons, they will be asked to respect the quarantine delay before participating in any business activities.

Events and gatherings
All our events have been postponed or cancelled. Our employees are no longer allowed to participate in any events, seminars or gatherings.

We are committed to providing the best possible service to our customers and partners, to ensure that you can continue digital communications with your own audience. In these critical moments if we can help please do not hesitate to contact us.


The Xpertdoc Team

Mise à jour sur la COVID-19

La propagation de la COVID-19 continue d’évoluer et, dans ce contexte, nous souhaitons vous informer que Xpertdoc suit de près la situation et que notre équipe a pris des mesures pour soutenir ses employé(e)s, clients et partenaires.

Nous ne prévoyons aucun impact sur la prestation de nos services et voulons assurer nos clients que nous mettons en œuvre notre plan de continuité des affaires, afin de garantir que vous continuiez à recevoir nos services, sans compromettre la santé et la sécurité de notre personnel.

Conformément aux recommandations des autorités gouvernementales du Québec, voici quelques-unes des mesures prises par Xpertdoc :

Travail à distance pour tou(te)s les employé(e)s
Nous avons demandé à tou(te)s nos employé(e)s de travailler à domicile. Notre plan de continuité des affaires comprend des arrangements de travail à distance pour assurer un service ininterrompu à nos clients et partenaires.

Hébergement et services infonuagiques
Nos fournisseurs nous ont assuré qu’il n’y avait pas d’impacts connus sur les services d’hébergement et infonuagiques. Ainsi, nous sommes convaincus d’être en mesure de gérer efficacement la livraison de nos services infonuagiques à tous nos clients.

Nous avons annulé tous nos voyages professionnels jusqu’à nouvel ordre, pour tou(te)s les employé(e)s. Si des employé(e)s ont voyagé ou doivent voyager pour des raisons personnelles, il(elle)s seront placé(e)s en quarantaine pour une durée de 14 jours, avant leur retour au travail.

Événements et rassemblements
Tous nos événements ont été reportés ou annulés. Nos employé(e)s ne sont plus autorisé(e)s à participer à des événements, séminaires ou rassemblements.

Nous nous engageons à fournir le meilleur service possible à nos clients et partenaires, afin de garantir que vous puissiez continuer vos opérations sans interruption. Dans ces moments critiques, nous sommes là pour vous aider. N’hésitez pas à communiquer avec nous si nécessaire.


L’équipe Xpertdoc