Delivering Extraordinary Member, Patient, and Employee Experience

Healthcare contact centers face a difficult challenge. Members and patients expect swift, compassionate, and secure resolution to inquiries about claims, benefits, and care coordination that can be both sensitive and urgent. While payors and providers are eager to meet this expectation, they have to overcome severe data fragmentation and meet strict HIPAA and compliance standards to do so. Contact center representatives can be stuck in the middle, between the pressing needs of the caller and internal processes that make resolving issues less than instantaneous.

Too often, the result is that employees have to endure undue stress while members and patients deal with frustration and uncertainty on their medical journeys. To change this, organizations need a modern platform that both embraces AI and is fundamentally engineered for the complexity of healthcare data environments.

Accelerating Operational Efficiency with AI

As healthcare organizations explore areas where AI can drive business value, the contact center is an attractive candidate. Even the most expert reps spend much of their time on repetitive tasks—such as navigating 20 to 60 disparate systems to piece together a full history—a prime target for AI automation. Perhaps more importantly, contact centers handle valuable, often high-stakes touchpoints, which can drive member loyalty, network satisfaction, and positive health outcomes.

Industry Expertise, Specialized Solutions, and Microsoft Technology

At Hitachi Solutions, we help healthcare customers take advantage of this opportunity by combining our deep domain experience, our 100% focus on Microsoft technology, and highly performant solutions we’ve developed through years of contact center modernization projects.

The foundation is Microsoft’s Contact Center as a Service (CCaaS) solution, built entirely on the secure, HIPAA-compliant foundation of the Microsoft cloud. Using Dynamics 365 Customer Service and Copilot for Service, this solution centralizes data and operations.

Healthcare organizations move away from disparate systems and toward a true, 360-degree view of their members and patients, a critical step toward effectively leveraging AI. In addition, Hitachi’s proprietary Consolidated Data Model and specialized solutions build on our industry expertise, with capabilities that specifically address member, provider, and group data. Our contact center solutions, like Intelligent Call Wrap-up, which simplifies post-call administration for representatives, streamline the automation of key workflows, delivering demonstrable value faster.

What Does this Mean for Member and Employee Experience?

Dramatically improved member experience

Members and patients want their urgent issues resolved swiftly and securely, contributing to overall care and trust. Our approach achieves this in specific, measurable ways:

• Faster, compassionate resolutions
  When contact centers have centralized data access, customers see their issues handled on the first contact more often. This improved resolution rate also frees representatives to focus more on customer contact, reducing wait times.
• Protected health information
  While securing PHI is vital, manual security processes can be laborious for callers, especially when they’re experiencing poor health. Streamlining security checks, like identity verification, allows customers to spend less time getting through authentication and more time on the issue that’s important to them.

Happier, more fulfilled employees

For representatives, a modern CCaaS solution means trading tedious administrative tasks for high-value interactions.

• Reduced administrative burden
  To meet compliance and reporting standards, healthcare organizations need to ensure that every customer contact is notated and reported accurately, putting a significant burden on representatives. Automation can relieve this burden, allowing them to focus more on empathy and critical thinking.
• Data visibility and confidence
  When representatives have access to comprehensive health histories, they can handle more patient and member issues quickly. This improves their sense of success and confidence, improving job satisfaction and making the change to AI-powered customer service a source of empowerment.

Making AI in the Contact Center Make Sense

In healthcare contact centers, AI can empower representatives to meet patient and member needs more quickly, securely, and reliably. To learn more about our approach to CCaaS implementation and contact center modernization, contact our team today or click to learn more about our 4-week assessment.