Maintaining compliance with HIPAA regulations while delivering exceptional customer service is of utmost importance in the healthcare industry. This article presents Insight Communications’ success story, highlighting their partnership with a Medicare Advantage plan and the implementation of a Digital Care campaign that maximized key performance indicators (KPIs) and customer experience (CX), all while ensuring strict compliance with HIPAA regulations.
Ensuring HIPAA Compliance:
Insight Communications and the Medicare Advantage provider prioritized HIPAA compliance by implementing rigorous protocols. To safeguard protected health information (PHI), Insight’s Customer Service representatives underwent comprehensive training. They were equipped with the necessary knowledge and skills to handle customer inquiries while protecting PHI and complying with HIPAA regulations.
Verifying Customer Identities and Authorized Information Sharing: Insight’s Customer Service representatives were trained to follow strict procedures when handling customer inquiries involving PHI. A crucial aspect of this training involved verifying customer identities before sharing any PHI. By implementing stringent identity verification measures, Insight ensured that customer information was only accessed and shared by authorized individuals.
Additionally, Insight’s representatives were well-versed in the principle of least privilege, sharing information only with authorized individuals who had a legitimate need for access. This practice further enhanced the security and confidentiality of customer information, aligning with the HIPAA regulations.
The Digital Care Campaign:
Building upon their commitment to HIPAA compliance, Insight Communications led the Digital Care campaign for the Medicare Advantage provider. This campaign focused on delivering accurate and proactive communication to plan members while ensuring the privacy and security of their PHI. By adhering to HIPAA regulations and following robust procedures, Insight’s Customer Service representatives effectively communicated member benefits, changes, and other relevant information, fostering trust and loyalty among plan members.
Key Performance Indicators (KPIs):
To measure the success of the Digital Care campaign, Insight Communications and the Medicare Advantage provider considered several KPIs:
- Adherence: Ensuring compliance with call handling procedures and protocols.
- Customer Satisfaction (CSAT): Evaluating member satisfaction through surveys and feedback.
- Net Promoter Score (NPS): Assessing member loyalty and willingness to recommend the plan.
- Abandonment Rate: Monitoring the percentage of calls abandoned by members.
- Grade of Service (GOS): Measuring the quality of interactions and service delivery.
- Average Speed of Answer (ASA): Determining the average time taken to answer member calls.
- Call Quality: Assessing the quality and effectiveness of customer interactions.
- Attrition: Tracking member retention and minimizing plan turnover.
Driving Customer Satisfaction and Business Success:
Insight Communications’ Digital Care campaign, aligned with HIPAA compliance and the designated KPIs, resulted in significant improvements in customer satisfaction, member retention rates, and overall business success for the Medicare Advantage provider. By providing personalized and timely communication while adhering to HIPAA regulations, Insight Communications demonstrated its commitment to protecting PHI and fostering positive member experiences.