The Centers for Medicare & Medicaid Services (CMS; www.cms.hhs.gov) embarked on an e-commerce venture of unprecedented magnitude with the development of its plan finder Web site, which is designed to connect Medicare beneficiaries with participating health insurance plans, as required by Medicare Part D. But Philadelphia-based CIGNA ($45.9 billion in assets), bearing in mind the preferences of elderly customers to speak directly with a customer service agent, has aimed its Medicare Part D-related technology investment at supporting contact center agents rather than directly at beneficiaries.
CIGNA partnered with Sunrise, Fla.-based medical supplies vendor NationsHealth to implement internal tools built to anticipate the questions and concerns of Medicare beneficiaries seeking a health insurance plan that best meets their needs, says Terri Swanson, vice president, senior care, CIGNA. "We feel that most people are going to want to have a conversation about this, and so we have focused our energy on building tools to support our agents who are on the phone," she says. The agents, Swanson adds, "talk live with members, trying to work through scenarios with them and helping them to understand their personal situations."
The thin-client, Web-based tools integrate various plan-specific data sources, such as housing formulary and pharmacy network information. They also integrate telephone call routing and scripting with the informational tools that draw on the data. The result, says Swanson, is that "Agents are working in an environment that is tailored to what they're doing, which is making and taking phone calls, researching the caller's questions, answering those questions, and being able to save the results in case the conversation needs to continue later."
Downstream, the applications are integrated further with the carrier's application and enrollment technology, Swanson says. Following a conversation that results in a request for an application, prospective plan members are sent a custom enrollment package including all the caller's relevant personal and plan information. "It's sort of an integrated, end-to-end process that starts with phone calls, and while it doesn't end with sending out an enrollment package, that's the first loop," she says. "At the heart of it is CRM-type technology that keeps track of those calls and allows the agent to return to them, or for a new agent to understand where the conversation stands in the process."
The tools fall within a larger marketing effort that includes television ads targeted at the Medicare-eligible population and an externally facing, informational-focused Web site designed for seniors. The carrier encourages potential members to call, according to Swanson. "We feel the Medicare-eligible population that we're serving is comfortable on the phone and wants to have a conversation with a person," she says.
2006 Health Insurance Outlook"The Medicare-eligible population ... wants to have a conversation with a person," says Terri Swanson, CIGNA.
Anthony O'Donnell has covered technology in the insurance industry since 2000, when he joined the editorial staff of Insurance & Technology. As an editor and reporter for I&T and the InformationWeek Financial Services of TechWeb he has written on all areas of information ... View Full Bio