Advanced Customer Service Application

Enterprise-wide workflow automation optimizes productivity and customer service
DST Health Solutions’ Advanced Customer Service Application is an integrated customer service and workflow tool that enables health plans to optimize productivity, accelerate issue follow-up and increase customer satisfaction. Automated support is provided across all departments, enhancing a health plan’s ability to efficiently respond to members, providers, brokers and employer groups. Developed using Java, J2EE and Web Portlet technology combined with the open source JBPM workflow engine, the application also offers significant integration opportunities.

Services

• Provides out-of-the-box call center functionality as well as associated workflow activities.
• Facilitates on-the-fly call resolution, issue routing and workflow enablement with flexible, user-selectable reporting and metrics.
• Integrates information flow to ensure coordinated delivery of customer service functions across multiple departments.
• Automatically routes customer issues for quick resolution and follow-up through pre-configured system rules.
• Delivers healthcare-focused issue resolution / business process support
• Provides integration points to allow e-mailing, messaging to external systems and telephony integration capabilities.
• Enables customer service reps to enter notes and route requests to the appropriate staff for follow-up and resolution.
• Identifies and categorizes call types using health plan defined codes.
• Streamlines complex call scenarios such as callbacks, provider calls about multiple member/claim issues, etc.
• Enables reps to quickly access inquiry screens to provide expedient service to members, employers and providers.

Values

• Accelerates resolution of customer inquiries by automating customer service functions across all departments.
• Maximizes enterprise-wide productivity by eliminating lengthy e-mail chains and multiple follow-up calls between departments.
• Provides increased productivity via drop lists with automated form completion, documentation and routing.
• Delivers single source Customer Service issue, action and resolution history repository supported by research, inquiry and reporting features.
• Assists customer compliance with Sarbanes-Oxley audit provisions through fully documented transaction logs and customer service rep decision points.
• Provides pre-configured workflows or can be customized to accommodate customer-specific requirements.
• Allows participation of subject area experts in call resolution based on your specific requirements.
• Shortens implementation time frames through pre configured issue and resolution library.
• Enables customer service reps to consistently respond to issues quickly and accurately through powerful issue knowledge database.

Figure 1. The Customer Service “main window” provides a launch point for staff to respond to incoming customer calls. Point-and-click navigation provides easy access to information so customer service representatives can respond quickly and efficiently to requests from any source. Pre-defined workflows guide customer service representatives through the steps required to move callers’ issues from request to resolution.

Figure 2. The Work Queue provides an on-line “to do” list for staff throughout the organization to respond to customers’ requests. Issues that require assistance from other areas are automatically routed from the call center to Work Queues in other areas. Investigation and follow-up is managed proactively across departments. The entire organization benefits from a coordinated approach to responding to customers’ service requests.

Figure 3. The Call Log provides detailed tracking of every action taken on a call, regardless of the source. Complete history on all incoming calls supports compliance with Sarbanes-Oxley audit provisions. Documented transaction logs are a useful tool for evaluating productivity and training needs.

For more about Advanced Customer Service Application, contact us at inforequests@dsthealthsolutions.com.