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For most health plans, the number one reason members call into the call center is related to finding a provider – and often to confirm a certain doctor is in-network.  It’s common for members to check the health plan’s online directory, but then call in to verify the information because they don’t trust the online information. This inefficient process can be rectified by maximizing the digital self-service tools plans have available to their members to help reduce call center volume (and costs).

In our recent webinar with Wellframe, HealthSparq’s General Manager, Mark Menton, joined Sarah Panock to discuss ways to reduce call volume while creating more effective methods to educate members and enhancing consumer engagement. Building on that conversation, below are some ways for health plans to think about maximizing their tools:

  1. Share provider details people want. Our consumer research shows that people look to their health plan first when they need a new provider. Health plans should provide as much information as possible about providers, including details such as specialties, languages spoken, and treatment philosophy. This can help members make informed decisions about their healthcare and can reduce the need for them to seek out information from other sources, while having the added benefit of building trust.
  2. Make sure online provider directories are easy to find and use. Clear button links, navigation menu items, homepage banners are just some ways to help ensure members can quickly and easily navigate to your public provider directory experience.  This can help reduce the number of calls from members who simply want to verify that a provider is in-network. As Mark mentioned in the webinar, health plans should “meet members where they are… and bring information to members instead of making them hunt for it.”
  3. Use clear, concise language to communicate that the providers who appear in search results are indeed in-network. This can help reduce confusion and minimize the number of calls from members who are unsure of a provider’s network status.
  4. Turn your customer service reps into trainers. If your members do need to call in, maximize the call by educating them about the self-service tools available to them. By walking members through the log-in process and showing them where to find the information they need, health plans can help increase the use of self-service digital tools and reduce the volume of calls to the call center.

Encouraging members to use self-service digital tools can save health plans time and money. To increase usage of these tools, plans should focus on delivering simple, user-friendly websites and apps that allow members to easily search for providers and understand costs. In doing so, health plans can help reduce the volume of calls to their call centers and improve the overall experience of their members.  To watch the full replay of the recent webinar with Wellframe, click here.