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Healthcare Member Communications Are Ripe for Transformation – Are You Prepared?

Posted on September 25, 2023 by SmartComm

By: John Zimmerer, VP of Industry Marketing, Insurance at Smart Communications

As parts of the world begin to open up, it’s easy to think that life, for both businesses and consumers, can simply pick up where we left off. But to do so would ignore the opportunities for improvement that we were forced to explore during the worst of the pandemic. One key lesson at the top of our list? The need for healthcare payers and providers to focus on timely, relevant and personalized member communications. While the pandemic provided the catalyst to accelerate the implementation of better digital conversation experiences, there’s still a long way to go, as revealed by data from J.D. Power:

54% of members do not understand if telehealth services are covered
48% believe the payer has not shown concern for their health since the pandemic began
Only 25% view the payer as their trusted partner
Only 36% feel the payer acts in their best interest

Clearly, there are major gaps in the way healthcare payers and providers think they are communicating to members, and how members are actually receiving those messages. In fact, recent research revealed that 63% of businesses think they are delivering excellent or very good communications to their customers, but only 51% of consumers give the same ratings to the communications they receive.

In a recent panel discussion at the Cognizant Healthcare Conference, three Smart Communications experts shared their perspectives on how the healthcare communications landscape is changing, and what leading payers and providers need to do to transform member experiences. While we invite you to view the full recording below, this post also highlights some of the key takeaways from the discussion and some best practices for delivering two-way, digital conversations.

Key Challenges Accelerating the Pace of Communication Transformation

The J.D. Power statistics show us that trust is low, and key messages, like those around telehealth coverage, are being missed or fall flat. Historically, this has been caused by both technological and operational limitations:

Static, mass email blasts to all customers delivering the same high-level messaging regardless of individual circumstances
Disconnected communication experiences that force members to provide the same information again and again across channels
An over-reliance on print for communicating key messages instead of a multichannel approach based on a customer’s stated preferences

These challenges have been felt across the four key areas of the healthcare member experience where it is most important to get communications right: member acquisition and enrollment, onboarding, care management and claims. If customers feel like they’re having suboptimal experiences everywhere they turn, it’s no wonder their frustration results in lower scores on the most critical customer satisfaction metrics.

Creating SMARTER Member Conversations

The good news is that many of these challenges can be solved. Leading payers and providers are taking the steps necessary to overcome traditional challenges and build the technical and operational infrastructure needed to transform the future of healthcare communications.

One powerful example of how to achieve the dream state of SMARTER customer conversations comes from Blue Shield of California, as shared at INNOVATE 2021. In their quest for 95% of communications to be digital-first, they pursued the following principles for success:

Make it Simple – only deliver communications that solve or pre-empt members’ needs and expectations. Rely on dynamic templates that drive consistency across channels but also increase agility. Then, streamline preview and approval processes.
Make it Useful – only deliver communications that provide relevant information in every channel, based on a combination of stated preferences and insights derived from advanced analytics.
Make it Mine – only deliver communications that are personalized, while keeping security top of mind.

These guiding principles are an important starting point for the larger question healthcare payers and providers are focused on – where are the biggest opportunities for improvement?

Here are just a few examples of how digital optimization can make a huge impact, along with real-world results:

Collecting Open Enrollment Choices Digitally

As the largest customer-owned health insurer in the U.S., supporting 140,000 employers across 5 states, Health Care Service Corporation (HCSC) realized the importance of transforming its open enrollment processes. HCSC had 250 manual, static forms which contained 20 unique sections with 3,000 different attributes that needed to be delivered to 26 downstream internal and external customers. The need for a highly scalable solution was especially evident here. HCSC worked with Smart Communications to eliminate manual forms in favor of a single, guided, digital interview process.

Using SmartIQ^TM, HCSC eliminated manual re-entry, reduced their support team training time and increased the amount of time employers had to make decisions, ultimately increasing productivity while lowering cost. Learn more about HCSC’s success in Transforming Manual Forms Processes into Exceptional Digital Experiences from INNOVATE 2021.

Streamline the Contract Generation Process

A leading managed healthcare and insurance provider sought to digitally optimize and improve their employer-sponsored plans. By working with Smart Communications, they managed to optimize a manual contract generation process involving multiple internal and external groups that took 2 weeks to just 1 business day—a 90% increase in efficiency. Additionally, when used in combination with SmartCOMM^TM for Salesforce, they were able to generate a contract in only 30 minutes, a dramatic improvement from where they were.

Globalization and Optimization Across the Enterprise – at Scale

The ability to optimize across multiple brands, jurisdictions and languages can vastly improve efficiency while reducing cost. By leveraging approachable technology, payers and providers can also optimize their workload throughout the organization, instead of being in a situation where certain tasks can only be completed by IT or specific subject matter experts.

With healthcare communications at an inflection point, taking proactive steps to align technology and operations for an optimal member experience is essential. And the cascading business benefits are measurable.

If you’d like to learn more about transforming healthcare member communications, check out our white paper “From Onboarding to Lifelong Relationships.”

Enhancing the Healthcare Customer Experience: The Guide to Medicare Advantage Plan Member Engagement

Posted on September 6, 2023 by SmartComm

By: John Zimmerer, VP of Healthcare Marketing at Smart Communications

In recent years, the healthcare industry has undergone a slow yet significant transformation, driven by advancements in technology, changes in regulatory policies, and a shift in plan member demographics. As a result, healthcare payers have been faced with the challenge of managing an increasingly complex and demanding customer base. This is especially true for Medicare Advantage plans, where customer communications play a critical role throughout the enrollment process and beyond. Everything from Annual Notice of Change (ANOC) documents to the Appeals and Grievances processes, these communications and customer journeys are crucial in building strong relationships with customers and improving overall Medicare Advantage plan member engagement.

The U.S. Centers for Medicare & Medicaid Services, or CMS, provides guidelines to help health insurers achieve compliance with US federal laws pertaining to Medicare Advantage (MA), Medicare Advantage Prescription Drug (MA-PD), Prescription Drug (PDP) and 1876 Cost Plans. CMS regulates a wide array of communications due to how broadly 42 CFR parts 417, 422, and 423 set the scope of that term. Because there’s a lot to keep track of here, compliance can be an issue for healthcare payers striving to protect member information while also enabling a streamlined, convenient digital customer experience.

While it's great to have these guidelines and model materials from CMS, everyone in a health payer's operations or IT departments knows that managing Medicare materials is as much art as it is science, causing an internal struggle between agility and compliance. What both departments need is a sophisticated, cloud CCM solution that can streamline the design, production, and management of Medicare marketing and communications materials.

In this article, we’ll focus on:

The current state of customer communications for Medicare Advantage plan enrollees.
The link between Medicare member engagement and payers’ administrative operations.
How healthcare payers can bridge the gap between customer experience and agility to enhance Medicare member engagement.
A subset of typical healthcare payer marketing communications.

RELATED READ | ‘The Ultimate Guide to CCM Software & Strategic Solutions’

Customer Communications for Medicare Advantage Plan Enrollment is Ripe for Transformation

Most payers are in the habit of printing and mailing materials every year. Many are also now posting these to their websites or member portals, most commonly as PDF files. It’s a rare payer that goes ‘all-in’ on digital delivery, even though, per 42 CFR subsections 422.2267(d) and 423.2267(d), all the materials listed above may be delivered electronically provided the enrollee has opted in. Even with this allotment, healthcare payers have historically struggled to manage customer communications effectively, leading to poor customer experiences and friction-filled member engagements.

The following communication types, which we’ll expand on at the end of this post, are just some of the documents which must be filed with CMS using the HPMS Marketing Module:

Annual Notice of Change (ANOC)
Evidence of Coverage (EOC)
Provider Directory
Pharmacy Directory
Drug Formulary

Explanation of Benefits (EOB)
Appeals and Grievances Notices

One of the biggest challenges facing healthcare payers is the sheer volume of customer communications they must handle. With so many different channels and touchpoints, it’s tough to ensure every customer receives timely and personalized communications via their channel of choice. This is particularly true during the Medicare Advantage plan enrollment process, where customers are often bombarded with confusing and overwhelming information.

In addition to the volume of communications, healthcare payers must also contend with the complexity of the information they are communicating. Medicare Advantage plans are notoriously complex, with many different rules, regulations, and benefits that can be difficult for customers to understand. As a result, healthcare payers must find ways to simplify this information and present it in a way that is easy for customers to digest while still providing pertinent information that is required by law, rule, or regulation.

Healthcare payers currently fall short in their efforts to manage customer communications effectively, leading to frustrated customers who may feel disconnected from their healthcare plan and are less likely to engage with their payer in the future. This has proven to lead to increased member churn and lower overall plan satisfaction. What’s more is that any negative member experiences can impact Star Ratings, which we’ll go over in the next section.

Read more about this in the commissioned report from Forrester: ‘Disjointed Experiences Cost Insurers Members and Money: The Bleak Reality of Member Experience with US Health Insurers’

Cloud-based Customer Communications Software Enhances Medicare Member Experience

To address these challenges, healthcare payers are increasingly turning to cloud-based customer communications management (CCM) software. This allows payers to manage all their customer communications from a single platform, providing greater visibility and control over the entire process and making possible a seamless omnichannel approach for members. With cloud-based customer communications management software, payers ensure that every customer receives timely and personalized communications on their preferred channel, while also simplifying the information they are presenting.

By leveraging cloud-based customer communications management software, payers can improve member engagements, reduce churn, and ultimately provide a better healthcare experience that has the possibility to enhance Medicare Advantage plan member engagement. As the healthcare industry continues to evolve, and member engagement remains a growing area of focus for leaders, customer communications will only become more important. That’s why it’s essential to invest in the right tools and technologies to stay ahead of the curve.

The Importance of Star Ratings and How CCM Software Can Help Medicare Member Engagement

When healthcare payers fail to engage with their members and make them feel seen and heard as individuals, it can lead to disenrollment and negatively impact Star Ratings. Additionally, the CMS Star Rating system is placing more emphasis on member experience and payer administrative operations rather than solely on clinical outcomes. These ratings have significant implications for healthcare payers as they can result in bonus payments for high-performing plans and influence the decisions of future members. According to a report from McKinsey, 56 percent of seniors reported that Star Ratings were one of the top features they considered when shopping for Medicare Advantage plans.

Check out our short video below to see how Grace, a Medicare Advantage enrollee, engages with her plan throughout the customer lifecycle, and see how SmartCOMM™ and SmartIQ™, two products in the Conversation Cloud from Smart Communications, make life better for her and her chosen Medicare Advantage Organization (MAO).

Below, we dig into the use cases featured in the video.

Annual Notice of Change (ANOC)

The Annual Notice of Change (ANOC) is a critical document for Medicare Advantage members as it informs them about any changes in their plan for the upcoming year. For health payers, managing the creation and distribution of ANOC can be a challenging, time-consuming task. Below are some of the common pain points, plus, how a leading cloud CCM solution can help alleviate them.

One of the most significant challenges of delivering and managing ANOC is the repetitive nature of the content across different plan types. Modern customer communications management (CCM) solutions employ a layered model that separates content from styling and branding, maximizing the use of reusable objects. This allows payers to create the content once to use across multiple plan documents, simplifying the translation efforts and minimizing the effort to comply with accessibility standards. With this ability to create personalized ANOC documents that reflect the unique needs of their members, while also minimizing redundant content, health payers can ensure their Medicare members feel empowered to manage their plans.

As many health payers have plans in multiple jurisdictions, which can complicate the ANOC process, having a solution that accounts for these variations is key. SmartCOMM’s Editions feature allows payers to create tailored ANOC documents for each jurisdiction they serve, ensuring that members receive accurate and relevant information as per their region.

Finally, the ANOC process often requires reviews and approvals from multiple stakeholders, which can lead to delays and errors. With a built-in workflow feature, payers can streamline the process of managing and tracking reviews and approvals in a centralized system. Ultimately, this reduces the risk of errors without sacrificing agility, ensuring that ANOC documents are delivered on time.

Though managing the ANOC can be a complex and time-consuming process, the right technology and tools help healthcare payers streamline the process of creating and delivering personalized, accurate ANOC documents to members. This helps improve the overall Medicare member engagement, leading to more renewals and higher Star Ratings in the long run.

Evidence of Coverage (EOC)

Providing members with accurate and comprehensive information about their healthcare benefits is crucial for payers. However, managing the Evidence of Coverage (EOC) is a complex and lengthy process as relevant details and data may exist across multiple core systems. Even more frustrating is the limited access to real-time eligibility and coverage information coupled with the fact that data which is available could be incorrect due to data entry errors.

The right cloud CCM software simplifies the process of managing and storing EOC documents as it enables easy access to member eligibility data, plan coverage details, and benefit limits in real-time. With the right integrations in place, customer communications management solutions can minimize errors and reduce administrative costs for payers. SmartCOMM, for instance, can seamlessly integrate with a wide range of core systems, such as policy systems and CRM, allowing for the easy personalization of information based on members' needs.

We understand that complex tables can be a pain point when it comes to managing EOC documents. Modern CCM solutions easily create complex tables that span multiple pages, including repetition of header and footer rows. This helps members easily comprehend their healthcare benefits, including what's covered, what's not, the costs, and their right to appeal.

Provider Directory

It is crucial to provide members with a comprehensive Provider Directory that is easy to access and find information in. However, traditional directories present several challenges that negatively impact satisfaction. These include:

The directory's size makes it costly and challenging to print
It can be difficult to keep the directory current as provider networks change

There’s a sub-par user experience especially when the directory is printed
High customer burden as members must sift through numerous listings to find the right provider

To provide the best possible outcomes and experience for members, payers should invest in a leading cloud CCM solution that enhance the Provider Directory for both members and providers. This means minimizing the number of directories that need to be printed, honoring member channel preferences, and creating one template that can be used for both print and digital versions which ensures consistency across all channels.

Our technology allows you to integrate data from various sources to create on demand the most up-to-date and personally relevant version of the Provider Directory. SmartCOMM can potentially present only the providers that match specific criteria (such as specialty area or location) as HTML versions may differ from print versions. This allows for a tailored web experiences to meet members' needs, such as only showing, for example, in-network acupuncture providers within 10 miles if that is what the member is seeking.

Pharmacy Directory

A Pharmacy Directory is a unique list of participating pharmacies, including preferred pharmacies where members receive the best prices. It is typically organized by state and then sorted by zip code, like a phone book. Providing members with an accurate and up-to-date Pharmacy Directory is a great way to prioritize Medicare Advantage plan member engagement.

Realistically, Pharmacy Directories present various challenges that can negatively impact member satisfaction. Just like the Provider Directories, members must wade through large documents to find out if their pharmacy is preferred, which can be challenging and time-consuming.

Payers should provide different experiences per channel, such as PDF or print versus web or mobile. This flexibility allows members to access Pharmacy Directory information in a way that is most convenient for them, leading to improved member satisfaction. By improving the Pharmacy Directory experience, members are empowered to easily find the pharmacies they need, ultimately leading to better health outcomes and less frustration toward health insurers.

Of course, this level of customization and personalization will require partnering with a CCM vendor who understands the nature of the health insurance industry. For more information on why Smart Communications is uniquely positioned to do so, read the report from Aspire, naming Smart Communications as a leader in Vendor Hosted SaaS Customer Communications Management (CCM).

Drug Formulary

Providing a comprehensive and up-to-date drug formulary to their members is a necessity for health insurers looking to enhance the member experience. The drug formulary is a high priority for the average Medicare Advantage, supplemental or prescription plan member, especially when they are on multiple maintenance medications. However, many common pain points can detract from the member experience, causing members to disengage altogether.

Like is the case with Provider and Pharmacy directories, one major pain point with a drug formulary is the lack of access to the most up-to-date list of drugs. With drugs being added, deleted, and changing tiers, it can be challenging for members to stay informed about the latest formulary. Additionally, traditional drug formularies can be a terse volume that lists medications categories (e.g., NSAIDs under analgesics), making it hard for individuals to navigate and find the information they need. SmartCOMM solves these problems by integrating with back-office systems and triggering the automatic generation of a new version of the drug formulary as soon as a drug is added, deleted, or changes tiers. This is particularly important for the HTML version, ensuring that web visitors have an up-to-the-minute drug formulary to reference that is always correct.

SmartCOMM also offers layout tools that make it easy to manage the large volume of information included in the drug formulary and create tables inside a PDF/print version. This creates a better member experience, making it easier for members to find the information they need quickly and without frustration. For health payers, being able to offer a customized drug formulary experience for their members, with easy access to the most up-to-date information in a user-friendly format can make or break the overall member experience.

Explanation of Benefits (EOB)

Payers know how critical the Explanation of Benefits (EOBs) are to a members' experience yet EOBs are often difficult for members to understand. This often leads to frustration, appeals, and grievances which are time-consuming and costly to the business. These bad experiences can also lead to a diminished brand reputation, lower Star Ratings, and even disenrollment.

That's where SmartCOMM comes in. Our platform offers a solution that improves the information architecture of EOB documents, making it easier for members to understand the reasons behind the insurer's payments or non-payments. By integrating charts and graphs, our platform visualizes where the member is in their out-of-pocket maximum or deductible, providing a clearer picture of the financial responsibilities. Additionally, you can include related education materials when generating EOBs based on claims included, which further educates members on what was or wasn’t paid and why or why not.

Moreover, our connected claims abilities will boost self-serviceability and help deflect calls from call centers, allowing Customer Service Representatives to focus on providing the highest level of service to members who need more attention. SmartCOMM's platform also offers various delivery options for EOBs, such as digital and print versions. This flexibility ensures that members receive their EOBs in the format they prefer, which can increase engagement and understanding.

By leveraging SmartCOMM's technology, payers can enhance the EOB experience for members, reduce appeals and grievances, and improve overall member satisfaction. Health insurers can also use the platform to generate clear and concise EOBs, increasing transparency and fostering trust between members and the organization.

Appeals and Grievances

For Medicare Advantage providers, Appeals and Grievances (A&G) are an inevitable part of the healthcare member experience. Members have the right to appeal how a claim was paid or file grievances for various reasons. Managing appeals and grievances can be a time-consuming and costly process for both the payer and the member. Not only do payers have mandated response times, which can be challenging to meet, there can also be a lack of transparency and high customer burden for members, including forms to fill out and mail/fax to the payer. For A&G employees, switching contexts between different tools can lead to reduced productivity and further delays.

SmartCOMM streamlines the appeals and grievances process, reducing costs and improving member satisfaction. Our platform integrates with systems of record, such as PegaSystems, allowing for quicker processing times and reducing the need for third parties in the review process.

Our flexible templates enable payers to generate all possible permutations of response, including acknowledgments, requests for more information, denials, and approvals, all based on input from a system of record or an A&G employee. This approach streamlines the communication process and ensures that the member receives clear and concise information about their appeal or grievance.

We also honor the member's preferred channel for generating the communication, which can improve member satisfaction and reduce the burden on your A&G employees. Additionally, SmartCOMM can integrate within other applications (e.g., Salesforce, Pega), helping employees to stay in context and improving their productivity.

Moving Medicare Advantage Communications to the Cloud

In addition to the use cases highlighted above, SmartCOMM is a great solution for managing other Medicare Advantage materials and marketing communications, including ID cards, Summary of Benefits and plan booklets. In fact, many healthcare payers use SmartIQ, our forms automation software, to help manage provider and partner contracts, group plan development, and enrollment.

By moving your communications to the cloud and utilizing SmartCOMM, you can transform your communications into engaging conversations that will help you meet your members' needs and reduce costs. From directories of participating pharmacies to drug formularies, from explanations of benefits to appeals and grievances, having the right systems and solutions in place can help health insurers save money, remain agile, and—most importantly—improve the medicare member experience.

With SmartCOMM, health insurers can improve Medicare member engagement and streamline communication processes, all while meeting regulatory requirements and staying ahead of the competition. So, why wait? Make the move and start reaping the benefits today!

If you’d like to learn more about how to member engagement, visit our Medicare Advantage page.

Achieving Digital Transformation the SMART Way

Posted on March 27, 2023 by SmartComm

By Hitesh Bhindi, Director of Professional Services at Smart Communications

According to IDC, worldwide spending on digital transformation initiatives will reach nearly $2 trillion by 2022. So, what’s keeping your organization from jumping onboard? Let’s face it, digital transformation for any organization large or small is a huge commitment, not to mention a big financial investment. There are reasons why some are hesitant to pull the trigger, but that doesn’t hide the fact that digital is here to stay. Transforming to a digital-first organization and in turn, selecting a modern customer communications management (CCM) platform are both critical decisions for any company that wishes to maintain its competitive edge.

While revamping your customer communications strategy and incorporating new technologies does invite certain complexities, the tradeoff of improved communications across a wide range of channels will be well worth it. But, before you reach out to your boss with an exciting new idea on how to push your organization along the digital route, take some time to think things through and develop a comprehensive plan of action.

Why Upgrade to a Modern, Cloud-Based CCM Solution?

It’s important to clarify why now is the time to modernize your customer communications strategy and emphasize the need for change. Shockingly, many people still have the mindset, “If it’s not broken, why fix it?” According to Forbes, a recent study found 83 percent of enterprise workloads will be running on cloud servers instead of on-premises platforms by 2020. The cloud has come of age! Companies that don’t embrace the cloud, and the internal and customer-facing benefits it affords, risk falling behind their competition.

How to Gain Buy-in Across Your Organization

Key to the success of a digital transformation project is employee engagement. Barriers to this often include people feeling that either the new program doesn’t relieve their pain points, or it was imposed on them with little or no input. It’s important to be aware of these sentiments within your organization to identify how going digital can help address their needs. In our latest whitepaper, Setting the Stage for Change in the Digital Age: How to Gain Organizational Buy-In, we reveal five key steps to follow that will help the process run smoothly.

Crafting a Plan for Digital Transformation

Once you’ve done your homework and connected with key stakeholders across your organization, it’s time to develop a proposal for your executive team. You’ll want to start by articulating how a cloud-based CCM will help your organization improve your communications. Then, you’ll need to address how you’ll update your operational model to match a new, digital-focused communications strategy. Using the data gathered during the fact-finding process, you can create a digital content roadmap highlighting where digital communications can be incorporated. Finally, you’ll want to showcase areas of opportunity for quick wins and demonstrate ROI early. Seems straightforward, right?

While it might not be a one-day project, it will be well worth the process!

4 Ways Forms Automation Can Enhance the Healthcare Member Experience

Posted on March 27, 2023 by SmartComm

By: John Zimmerer, VP of Healthcare Marketing at Smart Communications

It’s said that repetition is the key to mastery. With this in mind, anyone who has visited a doctor’s office or filed a claim with their health insurer should be an expert at filling out paperwork. Given all the advances elsewhere in healthcare, it sounds silly, right? Perhaps, though, not as silly as the fact that people are still expected to complete the same paperwork online and in-person. This certainly isn’t a great way to meet the expectation of helping consumers be seen and known as individuals. There is, however, an opportunity for insurers to become experts at creating an exceptional healthcare member experience.

In the case of manual processes and paper forms, the repetitive nature is more of a headache than anything else—for both payers and members alike. This approach has proven to be unsustainable and unsuccessful for meeting members’ needs and enhancing their trust in health insurers. Simply put, member expectations have exceeded the capabilities provided by static forms and one-way communications. Health insurers must rethink how they engage with members and adopt solutions that enable interactive, two-way conversations.

When it comes to optimizing the healthcare member experience and building loyalty, unfortunately it’s time for health insurers to play catch up. To dive into the topic a bit more, we commissioned Forrester to conduct research into the current state of member experience. The resulting report, Disjointed Experiences Cost Insurers Members and Money: The Bleak Reality of Member Experience with US Health Insurers, highlights the opportunities available for health insurers to make improvements to each stage in a member’s journey, such as collecting member information. Something to keep in mind: when we refer to the member journey, this is the typical pathway members take with an insurer—engaging with touchpoints along the way—to achieve a particular goal.

Fortunately, there are technology resources available today that can take the member experience to a new level nearly immediately. SmartIQ, for example, gives health insurers a competitive advantage and the ability to quickly implement or extend a digital-first strategy. Using a forms automation solution helps to digitize, optimize and modernize the forms process across the healthcare member experience.

This article dives into the tangible benefits of digital forms and specifically highlights how health insurers can:

Enhance the healthcare member experience by making meaningful, incremental improvements
Drive down call volume and improve the member experience with claim-related forms
Transform the manual, paper-based processes to digital, intuitive experiences
Optimize the processes for member-submitted claims and adjudication

1. Use Low-Code Solutions to Eliminate Manual Forms

In healthcare, forms are everywhere and at every stage of the member lifecycle. While forms are just one stage of a member’s journey, they’re often the most important. They can provide a starting point for two-way, interactive conversations—giving insurers the ability to gain deeper insight into their members’ needs and expectations and respond in a manner that’s personalized and meaningful.

The process for gathering the necessary member data isn’t always easy or efficient—especially since paper forms lack the interactivity that drives rich, in-depth engagement and the ability for payers to meet members wherever they are. Research even showed that nearly 60% of consumers abandon a form if the process is too difficult. Even worse, manual processes create a transactional relationship between member and payer which isn’t ideal for an industry as intimate as health insurance.

A low-code forms automation solution helps health insurers enhance member engagement by paving the way for a better end-to-end experience. It removes the additional hoops that consumers must jump through when filing or appealing claims. Eliminating manual forms in favor of digital solutions creates a less burdensome member experience and improves operational efficiency for the payer. With digital processes in place, payers can focus on building member loyalty and trust through empathetic conversations at every interaction.

A person’s health and financial security are both intensely subjective and personal topics. And, depending on an individual’s situation, there’s no shortage of emotions when members interact with payers. That’s why it’s key to create easier ways for members to submit information in critical journeys like submitting claims and filing appeals. This will reduce the level of stress and anxiety during these engagements.

RELATED READING | ‘Eliminate Healthcare Forms and Boost Member Satisfaction with Cloud Technology’

2. Improve the Healthcare Member Experience with SMARTER Conversations

The key to improving member engagement is creating more seamless, efficient interactions. Static or fillable PDFs and web forms don’t allow payers to nurture interactive conversations that provide the deeper insights they need to meet members’ needs.

As previously mentioned, the health insurance industry is lagging in digital transformation—a fact that’s creating friction in attracting new members and keeping them loyal. Improvement starts with identifying and measuring key member journeys, with the goal of prioritizing changes. Through this audit, organizations can identify processes and functions that may benefit from automation, specifically looking for opportunities to make incremental improvements. These are often manual tasks, such as responding and following up on claims-related interactions. Automating these processes can enhance both the member and employee experiences.

The opportunity to improve the healthcare member experience is perhaps most visible within the claims process. Members submit claims for a variety of reasons. One common type of claim is a request for reimbursement for covered items purchased over the counter. Requests for reimbursement for COVID-19 test kits are a great example of how insurers should modify existing processes to comply with new and changing mandates. Using cloud technology to tackle these types of reimbursement requests will result in faster settlement times and ultimately, happier members and employees.

YOU MIGHT ALSO LIKE | ‘Optimize Digital Forms for COVID-19 Claims’

3. Enable Intelligent Conversations for Claims Appeals

Despite a health insurer’s best efforts, there are occasionally issues with how claims are adjudicated. Sometimes, the issue is related to the timing of when claims are received versus the chronological order of dates of service. When something is amiss, a member will want to appeal the initial determination.

Unfortunately, there are several problems with the current state of claims appeals. When questions arise, members are often asked to contact the call center and are then instructed to submit a generic appeal form to request a redetermination. This form is an important step along the claims redetermination pathway.

But what happens when agents are bogged down or lack the training necessary to help members solve even this basic problem? Furthermore, often completing the necessary forms are highly manual efforts for both payer and member and unfortunately do not include any pre-populated, known information based on the member’s information or specific claim.

This immediately leads to member dissatisfaction, lack of trust and inability for members to self-service a claims appeal. Even though Forrester has found speaking on the phone was the most reliable channel for members, that same research shows that 51% were dissatisfied with their experience with the call center.

After contacting the call center, members may have a difficult time simply finding an appeal form. Once they do find the correct form, there’s an additional headache of filling out and submitting the form. This method forces a member to print and mail or fax the form (along with supporting documents) to the insurance company and wait for a response. It’s inconvenient for both the payer and member as it adds additional time to get to a resolution.

There are many other pitfalls to this approach, such as:

Members skipping a required field or forgetting an attachment
Issues with imaging and processing the form, which leads to incomplete or inaccurate information being entered and processed on the business side
Members accidentally sending the form to the wrong address or the form being lost in transit
Incomplete forms, which leads to delays and increases frustration for member and operational expenses for the payer

Alternatively, and ideally, the appeal form should be an intelligent interview providing a guided member experience. A link to the interview can be embedded directly into the explanation of benefits. That way, all the data related to a specific claim can be pre-populated, allowing the member to focus on the reason for requesting a redetermination. The member can easily download a copy of the form and a copy can be attached to a case for review by an Appeals and Grievances member. With this approach, insurers can effectively communicate via the member’s channel of choice and maintain all communications seamlessly.

4. Automate the Healthcare Forms Process with Cloud Technology

The need and desire to automate processes continues to spread across most enterprises. This evolution has been integral to the success of workforces. In industries like healthcare, however, disjointed systems continue to create siloed approaches to even the simplest processes.

Cloud technology has made easier work of implementing automated solutions, as well as refining digitized business processes. Considering the healthcare forms process, some benefits of automating with cloud technology are:

Improved healthcare member experience

When automated, the healthcare member experience is transformed from a ‘hunt and hope’ approach to a personalized, ‘how may we help you?’ conversation. The payer already has access to the data in their systems of record without the need for the member to re-enter previously provided information. Interactions are member-led throughout the entire process and broken down into bite-sized chunks that are easily consumable. Since files, images or receipts can easily be attached, there’s no need to print, fax or mail anything. An e-signature process delivers digital data to all stakeholders. This results in improved CAHPS/HEDIS (STAR ratings), CX Index and NPS scores. And, most importantly, a reduction in burden on the member.

Increased efficiency throughout the claims process

Insurers can use the same technology to reimagine member-submitted claims. By moving business logic up front and limiting the amount of data entry required through integration with systems of record, fewer claim forms are rejected and reprocessed. Starting and staying digital means payers can eliminate scanning and using OCR software on physical forms. Ultimately, this reduces processing times and improves financial performance across the organization.

Lower regulatory risk

Using a truly digital forms solution, more member-submitted claims can be auto-adjudicated. Member-submitted claims can easily be paid within regulated timeframes, typically 30 days from receipt, reducing the risk of escalated appeals or grievances. This also eliminates fees, fines or penalties, as well as a negative reputation or public relations issues.

Conclusion

As health insurers identify ways to enhance the member experience, it all must start by understanding members as individuals – meeting them where they are and providing interactions that are tailored and relevant. Digitizing form-based processes, for example, can meaningfully move the needle on the end-to-end member experience. Give members a chance to rebuild trust in the healthcare industry by deploying sophisticated cloud technology to meet them at any time or place.

Forms automation solutions like SmartIQ provide near-term benefits in a long-term digital transformation journey—something that is desperately needed to remove all barriers to better member conversations. This will optimize the member experience and help employees on the insurers’ claims teams foster exceptional interactions at every touchpoint across the entire member experience.

It’s safe to say that automated solutions powered by cloud technology are critical to creating memorable experiences that boost member engagement and foster a level of care that insurers can be proud to offer their consumers.

Now that’s a process worth repeating.

To discover how low-code solutions can help health insurers boost member engagement, access our on-demand webinar to see SmartIQ in action. Or, request a demo for more information about how payers can benefit from the SmartIQ solution.

Enterprises That Benefit Most From Customer Communications Management Software

Posted on August 12, 2022 by SmartComm

By: Chris Murphy, VP of Product Marketing, Smart Communications

Enterprises around the world are navigating a digital landscape and customer expectations that are changing faster than ever, leading many organizations to rethink how they interact with customers—especially companies within highly regulated industries like financial services, healthcare and insurance, as well as the public sector. As these enterprises engage with customers at critical moments in their lives, it’s imperative that one-way, transactional communications be replaced with two-way, interactive conversations that offer a seamless customer experience. This is where cloud-native customer communications management (CCM) software can help.

An unfortunate truth is that outdated, legacy CCM systems do not provide the necessary agility to meet customers’ growing expectations. Companies that implement pure cloud CCM will be more capable of achieving the unmatched levels of innovation, agility and scalability that today’s customers require.

In this post, we’ll explore how making the shift from legacy, manual systems to a cloud-based CCM solution can help enterprises remain agile, competitive and compliant, as well as some of the main challenges that can be solved with CCM.

Why is Cloud CCM a Necessity for Highly Regulated Industries?

Early adopters of cloud-based CCM are already noticing the benefits of making an investment in sophisticated cloud software. In fact, the IDC MarketScape: Worldwide Customer Communications Management Applications 2022 stated that organizations cited a 26% improvement in customer satisfaction as a result of embracing digital transformation. Enterprises need the right systems to help them decrease friction while still gathering the details and information required to help customers achieve their goals and remain satisfied.

As noted earlier in the post, highly regulated industries often interact with people at their most vulnerable or critical moments: a car accident, a first-time home buying experience or claims appeal after a major health issue. Navigating these life milestones is difficult enough, for both the customer and the company’s employees. With less time spent on paper heavy, manual tasks, employees have more room to be empathetic and focus on providing an exceptional customer experience.

When every customer interaction is high-stakes, enterprises within the insurance, financial services and healthcare industries require solutions that provide deeper visibility into every customer touch point, increased efficiency and the ability to deliver omnichannel communications – all of which is only achievable with a cloud-first approach.

How Cloud-based CCM Solutions Enhance Business Efficiency

In our fast-paced world, efficiency continues to be a main driver for businesses. The way we work and live has shifted exponentially over the last several years, making the customers of today more digitally savvy than ever. People have become accustomed to working out of their homes with systems and tools they once never used. Now, businesses are playing catch up and they need future-ready ways to help them remain efficient at scale. Rather than taking a reactive approach to these changes, proactive enterprises understand the cost savings and agility that come from cloud-based CCM solutions. Some of those include:

Greater Visibility into Delivering Compliant Communications. When considering the need for compliance and the ever-changing regulations, visibility into the language being used across forms and other external communications can make or break a brand, like manually searching for and replacing dozens of instances where language may be outdated or replaced for any number of reasons. This could be due to compliance regulations that dictate the way a contract is formatted. However, a sophisticated CCM solution that leverages the power of the cloud can search an entire library of communications for fragments (including sentences, logos or pre-made E-signatures) and replace it with the correct content. Minute details, like font sizing or color, can also be updated easily as per regulatory standards, such as a Terms and Conditions section in a document.
Reducing Administrative Burden on the IT Department. Another big benefit of utilizing cloud technology is for IT departments. Unlike legacy, on-premise tools, a cloud-based customer communications management solution reduces the burden on IT and frees up resources/budget that allows for more innovative initiatives. Without the added weight of managing or updating software and systems, IT teams can spend more time taking a strategic approach to the products or services a company offers.
Increased Control and Ownership for Business Users. The business user has more control and ownership of the software and can enjoy seamless updates (managed by the vendor) and flexibility that isn’t possible with on-premise tools. This is especially important when considering the hybrid or fully remote working situations across large workforces. With cloud software, customer service representatives have the needed flexibility to provide a great customer experience from anywhere in the world—without sacrificing customer safety or risking non-compliance.

The above benefits certainly extend to highly regulated industries like financial services, insurance and healthcare. In the rest of this post, we’ll examine some additional benefits of CCM for each of those industries.

Customer Communications Management Benefits for Healthcare

The healthcare industry, for good reason, has some of the toughest regulations and compliance-related expectations. To remain compliant and agile, while also focusing on patient satisfaction, requires health insurers to rethink the systems and solutions they use to manage the end-to-end customer experience. In addition to those top priorities, key findings from a recent Forrester report highlighted these main challenges facing health insurers:

Health insurance members prefer offline channels for customer service due to unsatisfactory digital experiences
51% of customers are dissatisfied with phone interactions
Insurers find it challenging to provide a seamless, personalized digital experience
Insurers’ top priorities indicate a focus on acquisition rather than improving current members’ experience

The above challenges can be solved by investing in a customer communications management solution that leverages the power of the cloud and provides health insurers with a strategic approach to improving customer experience—from acquisition through servicing—and ultimately improving retention. Consolidating CCM use cases onto a single enterprise-wide platform also improves operating efficiency and increases speed to market.

Helping members be seen and known as individuals will take a concerted effort to do away with manual processes and tools that only offer a one-way transaction. Health insurers need to reimagine how they engage with members and adopt digital solutions that enable interactive, two-way conversations.

YOU MIGHT ALSO LIKE | ‘Connecting the Healthcare Claims Experience’

Customer Communications Management Benefits for Insurance Providers

Not only are customer needs very similar in both the healthcare and insurance industries, the compliance and regulatory requirements are, too. Protecting customer data and reducing errors is critical when thinking of the total customer journey. In addition to these drivers, the following are also top priorities for companies in the insurance industry:

Reducing cycle time and NIGO rates for claims to increase customer satisfaction and associated renewals
Reducing dependency on IT to create new reports, reduce template maintenance and number of templates
Eliminating disparate systems to provide for a more cohesive approach to managing customer conversations

Unfortunately, insurance companies that are hanging onto legacy technology might also be hindering speed-to-market innovation, limiting digital-first strategies and inhibiting the ability to respond to rapidly evolving product and customer preferences. To overcome these challenges and meet strategic priorities across the industry, insurers must invest in CCM solutions that help them foster two-way, interactive customer communications with agility and efficiency.

Manual, analog systems might be the expectation for insurers, but their customers are digitally savvy and have adjusted their expectations based on how they do business with companies that have already digitized and automated core business functions. To become a truly customer-centric organization while also remaining competitive, insurers must accelerate their innovation by adopting pure cloud, digital platforms that work seamlessly with policy, claims, billing systems and other enterprise software tools. This approach will allow for personalization and omnichannel delivery across the entire insurance lifecycle.

KEEP READING | ‘Becoming a Digital First Claims Organization’

Customer Communications Management Benefits for Financial Services Institutions

Banks and financial institutions have always competed for loyalty and wallet share based on delivering the best customer experience (CX), which has only become more difficult as new digital channels of engagement pop up every day. According to a March 2022 report from Celent, 58% of banks say “it is more challenging to win and retain customers than 12 months ago.” Competition from fintechs and non-bank lenders means banks need to step up their digital game.

CCM software solutions enable banks to engage customers with personalized, relevant communications in real time across a growing number of channels and engagement points, from getting a loan to onboarding investments to statements and customer service transactions. CCM platforms built for enterprise scalability enable banks to manage and deliver millions of documents or digital messages every day, including marketing offers, product information, compliance disclosures, renewal notifications, delinquency notices, just to name a few.

Meeting customers where they are while delivering the right messaging across all channels is just one way banks and other financial institutions can not only cut down on customer frustration, but also reduce compliance risks by managing communication templates. Banks can achieve massive cost savings by reducing paper and postage costs for ongoing communications. According to Forrester, one bank saved $16.7 million in overall costs by modernizing its CCM platform and shifting to digital communications.

Solving these challenges is at the forefront of the mind for many leaders in the financial services industry, as well as how to:

Support digital-first, two-way conversations that encompass the entire customer lifecycle, beyond sales
Provide customers with seamless transitions between in-person and virtual communications without friction
Remain compliant and protective of customer data while still providing flexibility throughout the various touchpoints

Financial institutions and banks are beginning to operate with a new customer experience paradigm. The old standard of reactive, one-way interactions is no longer accepted by a digitally equipped consumer base. Instead, banks and financial institutions have begun the process of adopting systems that can meet these increasing customer demands and allow remote or hybrid workers to account for gaps, no matter where they’re working from.

This digitalization goes beyond delivering documents or signing contracts; two historic use cases of early CCM tools. Customers can now be empowered to create their own journey, so to speak, when provided with digital-first, interactive conversations across the various engagement mechanisms that exist (e.g. website, chatbots, apps, in-person, phone). These capabilities support a customer-centric approach that is enabling financial services institutions to win customers and grow deposits.

READ THE REPORT | ‘IDC Industry Spotlight: Empathy at Scale at the Pace of Digital in Financial Services’

Why Smart Communications

Interactions across the insurance, financial services and healthcare industries are often stressful and/or high-stakes. This means it’s even more important than ever to deliver a customer experience that accounts for these factors. In fact, recent benchmark data from Smart Communications revealed that communications are important to 81% of consumers’ overall experience with a company—a high percentage when considering the various factors included in the end-to-end customer experience.

As one of the only CCM providers in the space that is fully committed to a cloud-first approach, Smart Communications has enabled many enterprises with the ability to shift from one-way, transactional communications to two-way, interactive conversations. This is one reason why we’ve been recently recognized on the Aspire Leaderboard for the strength of our solutions, strategic vision and global reach. In addition, Aragon, IDC, Gartner and other analysts have named us as a leader in our industry.

When considering the unique and specific needs in highly regulated industries, Smart Communications takes compliance and data safety seriously. We’re certified compliant by an independent third party and maintain HIPAA, ISO 27001, PCI-DSS, SOC 1 and SOC 2 certifications. This makes it possible for enterprises to provide contextual, compliant communications across the various channels their customers prefer.

Smart Communications is uniquely positioned to help enterprises in highly regulated industries realize a better way to manage customer communications. To learn more about how our pure cloud-native CCM software helps enterprises better serve their customers and remain strategic, check out the Aspire Leaderboard for Customer Communications Management.

How to Access and Use the 2022 Aspire CCM-CXM Leaderboard

Posted on July 29, 2022 by SmartComm

By: Chris Murphy, VP of Product Marketing, Smart Communications

Analysts agree that there’s been a major shift to the cloud in the customer communications management (CCM) space – driven by customers’ increasing preference for digital, plus unprecedented levels of innovation in the technology space. As the first CCM provider to fully embrace and harness the benefits of cloud technology, we’re pretty excited (not to mention proud) that the market is following our lead. But this strategic sea-change makes it all the more critical for companies looking to invest in new technology to find resources they can trust to help them make an informed decision. And when it comes to trusted resources in the CCM marketplace, the Aspire CCM-CXM Leaderboard provides in-depth analysis and advice for leading enterprises to make the most informed decisions about their technology investments.

Customer experience (CX) expert, Kaspar Roos, and his global team of market research analysts are highly respected in the CCM and CX industries. Since 2015, the firm has been providing highly specialized independent insights, evaluation and advice to empower enterprises, software providers and business advisories to better understand this evolving market. In fact, Aspire established the Leaderboard to help capture this evolution—and to help businesses understand how various CCM-CXM providers compare on a range of capabilities and strategic direction.

A Dynamic CCM-CXM Assessment Tool that Delivers Deep Insight

The Leaderboard’s interactive capabilities make it easy to visualize where various CCM vendors rank in the market. Users have the added ability to customize that ranking based on a range of factors including business model, CCM maturity, strategic focus, cloud maturity and more. Results can be further filtered based on specific categories and use cases, such as industry, target market and company size, for fine-tuned analysis.

The 2022 Leaderboard has been updated to reflect the changing market. Whereas previous Leaderboards ranked vendors on a single grid, this year’s tool allows users to select from several different grids depending on their organizational needs. In this post, we’ll focus on two of the grids where CCM is the primary focus: AnyPrem and Vendor-hosted SaaS.

At Smart Communications, we believe there is no one-size fits all approach. However, we’ve helped countless customers over the years to evolve from a more traditional, on-premise or hosted model to fully realize and harness the myriad of benefits of a vendor-hosted SaaS CCM solution.

“Cloud is a strong differentiator for Smart Communications. The company was one of the first in the industry to move toward SaaS and it has embraced a cloud-native, DevOps way of working since the mid-2010s” – Aspire Leaderboard 2022

Follow These Steps to Get Started

While the 2022 Aspire CCM-CXM Leaderboard is designed to remove complexity and provide clear analysis to support CCM-CXM decision-making, it does require a few more steps to access than your average static analyst report. Here are some tips to help you navigate the updated Leaderboard and find the optimal CCM solution for your organization.

Step 1: Do Your Homework

The ability to customize this tool is what really sets it apart, so start by getting very clear about what you need. Review any information you’ve already collected in a request for information (RFI). Evaluate all the possible criteria, prioritize feature sets and make sure you have a clear strategic vision so you can look for vendors whose trajectory aligns.

If you’re not sure where to start, ask yourself:

What are our key use cases?
Which departments will benefit from this investment?
What technology will help us focus on what we do best?
What does our existing tech ecosystem look like?
What core systems are we looking to extend the value of?

With customer expectations changing daily and the digital landscape continuing to expand, cloud is decidedly the way of the future. By adopting a pure cloud solution, companies can deliver seamless customer experiences with dynamic, two-way conversations—at unmatched speed and scale.

What to Look for in an Enterprise CCM Solution

Every organization has unique challenges and goals, and the best solution will align most closely to those needs. However, the things we know are important to end customers today when it comes to communications are often only achievable with cloud—including channel preference, relevance, frequency and timing. A pure cloud CCM solution provides the ability to manage the complexity of omnichannel communications, a holistic view of the customer, rapid response times and seamless integration with core systems, among other capabilities.

Security is always top of mind, particularly for highly-regulated industries such as insurance, financial services and healthcare. Look for a solution with enterprise-grade security and privacy standards such as role-based access, granular permissions and standard certifications. If you’re replacing a home-grown or legacy communications application, it’s also important to choose a vendor that offers migration support to maintain both communications and brand continuity.

The Aspire Leaderboard (and our very own Cloud Buyer’s Guide) include questions you should ask potential vendors. The bottom line is this: legacy on-premise CCM solutions simply cannot meet the moment for enterprises or their customers.

Step 2: Create Your Aspire profile

Now that you know what you’re looking for, you can set up your Aspire profile using our complimentary link. Start by registering to gain access to the Aspire Portal by entering some basic information and choosing a password.

Next, you’ll get an email from Aspire to activate your registration. From there, you can login to the portal and set up your profile. Simply follow the on-screen steps and fill in the requested information about your organization and role. While this takes a couple of minutes, it helps to personalize the experience so you can get the insights you need to make the best investment for your company.

Step 3: Choose Your Own Adventure

Now comes the fun part. Once you’ve completed your profile, you can access the Leaderboard and customize your view. Look for the Segmentation Grid drop-down menu in the top right corner.

For example, if your organization is focused on a cloud-first, SaaS approach, start by selecting Vendor-hosted SaaS CCM from the drop-down menu. This evaluation looks at vendors, like Smart Communications, who have developed cloud-native software offered “as a service,” either using their own data center or by relying on public infrastructure such as Azure or AWS.

One advantage of choosing a SaaS vendor is that they’re responsible for data security, making things like certification, regulatory compliance and privacy-by-design even more essential. In addition, SaaS solutions typically support continuous deployment, also known as evergreen IT, and use agile or DevOps software development methodologies. This makes it easier for companies to spend more time focused on what really matters—engaging meaningfully with customers—and less time on software (and hardware) maintenance.

For organizations looking to deploy a CCM solution that’s either on-premise or in a hosted, public, virtual private or hybrid cloud configuration due to security requirements, choose AnyPrem CCM Software assessment from the drop-down menu.

Many of the vendors in this grid “have reworked and repackaged their legacy CCM solutions for containerized, serverless environments.” Smart Communications appears in this grid, however, because we have adapted our cloud solution to work in a hybrid fashion – keeping all customer data within an organization’s domain – while still being able to benefit from all that a cloud solution offers. We recognize that customers are all on a cloud journey—and we have multiple options depending on where you are on that journey, and a pathway to get you to the next phase when you’re ready.

“All in all, Smart Communications has had a very good 2021 and continues to align its development with the direction of the market.” – Aspire Leaderboard 2022

As an established thought leader in customer communications, Aspire has identified an additional emerging category that they’re calling Communications Experience Management or Communications Experience Platforms (CXM/CXP). This is another assessment to consider.

According to Aspire, these vendors have combined CCM software with other CX systems—for example, business intelligence dashboards, customer data platforms, marketing automation, journey visualization and orchestration, and multi-variate testing. The CXP grid assesses both technology vendors and service providers who offer these capabilities as part of a single cloud (SaaS or AnyPrem) or hosted managed services platform.

Step 4: Customize. Prioritize. Assess. Repeat.

The best approach for your organization depends entirely on your unique requirements, strategic priorities and cloud maturity. While we’re proud to have paved the way for the shift to cloud in CCM—and that Aspire is recognizing this evolution—the beauty of the Leaderboard is that it dynamically responds to what matters to you.

As a trusted industry advisor, Aspire has analyzed and segmented the capabilities, strategy and market presence of multiple vendors to help you make the best possible decision. You can keep fine-tuning the assessment based on different use cases, priorities and strategies, and then save your filtered view for each grid you create. You can even create customized URLs to share with colleagues and reference as you continue to research technology options. The Leaderboard also includes customer quotes and vendor content, so be sure to check out the vendor profiles as well.

The Power of Dynamic, Specialized Insights for Informed Decisions

Investing in a new technology solution or platform is a big decision—and a challenging one. That’s why we’re excited to share this dynamic tool with organizations at any stage of the CCM journey to help you make an informed decision and achieve your strategic goals.

At Smart Communications, we pride ourselves on delivering business value and innovation to enterprise organizations across industries and borders, so you can have SMARTER two-way conversations with your customers. As the only company enabling enterprises to deliver personalized, omnichannel conversations across the entire customer experience, we believe we are uniquely positioned to help you engage more meaningfully, embrace the digital-first world and achieve your strategic goals. And, we’re thrilled that the most trusted advisor in our industry agrees.

“Smart Communications is an excellent fit for enterprises in the market for a modern and high-quality cloud-based CCM solution, especially for complex interactive use cases in addition to batch.”– Aspire Leaderboard 2022

Ready to Start Assessing?

Investing in Empathy: 4 Ways Financial Services Firms Are Improving Customer Experience

Posted on March 29, 2022 by SmartComm

By: Marc DeCastro, Research Director, Consumer Banking, IDC, Guest Blogger

If you ask most financial services executives if being empathetic is part of their collective DNA, most will surely tell you that is the case. And no doubt they are sincere. However, asking an executive if they run an empathetic organization is akin to asking someone if they are a nice person. Most people feel they are nice but may not fully understand what it really means to be nice.

The same is true with empathy in financial services. Delivering an empathetic financial experience involves keeping the customer at the center while engaging the customer using both available data and technology on their channel of choice. Data is really the key here when trying to deliver empathy in financial services, as data provides the insight required before, during, and even after the engagement has happened.

As consumers shift to digital-first interactions, and in some cases digital-only engagement, with their financial institutions, this empathetic experience must be able to be delivered seamlessly across both digital and physical channels. If your customers find that they have a better experience when dealing with a bank employee on a particular issue or question, they will likely continue to use that channel while avoiding digital options. This is probably not what most institutions want; they want to be able to deliver the best experience possible on the channel of preference and deliver this at scale.

An example of this might be a customer who asks a question about a new product or feature using SMS text messaging. Engaging with that customer across SMS might make sense up to a certain point. However, the customer may eventually need to be directed to a website, mobile app, or bank employee if the conversation becomes too complex.

Delivering this empathetic experience boils down to two main themes. First, provide predictable communications that are personalized and are contextually aware of current and previous engagements. Communication is at the foundation of every interaction and engagement during all steps of the customer’s financial journey. Allow customers the flexibility of choosing their channel, then provide a continual flow of conversations without the need for customers to repeat information. These communications need to be capable of producing results in real time, both during customer acquisition and account servicing.

The second theme is about loyalty and building lifetime value. Achieving this requires the financial institution to focus less on pushing a transaction through from point A to point B and focus more on providing more personalized experiences and advice using contextual guidance provided by the customer and obtained through existing data points. Loyalty is something that is built over time as the institution shows not only that they care about the financial needs of their customer, but that they are able to guide them to either a different service or a resolution to an issue that makes sense and provides real-time actionable advice, like “Click here to accept” or “Select a time for one of our employees to reach out to you.”

Where to Invest in Customer Experience

Improving customer experience is a top priority for financial services executives. In fact, IDC surveyed 116 financial service executives in Feb 2021 and the top three priorities were revenue growth, improving customer experience and satisfaction, and improving operational efficiencies. There are four areas of focus that should drive investment in technology solutions to help improve customer experience. They are:

Customer Intelligence. Investments here need to be able to capture as many points of data as possible, both data generated within the institution as well as third-party data sources. In order to build or provide solutions that can personalize experiences based on the context of the engagement, there must be a foundational layer of intelligence to draw from, otherwise personalization becomes difficult, if not impossible. With the right amount of customer intelligence, it leads itself nicely into the next strategic initiative, product innovation.
Product Innovation. Innovation on traditional bank products and services can often be more about policy, and less about technology. Instant access to deposited checks as opposed to putting legal, but inconvenient holds for customers is simply a decision in policy based on risk of fraud. However, other innovation can leverage modern technology that provides some level of innovation. For example, a small but growing number of institutions have provided their deposit account customers with access to their direct deposit payroll a few days prior to the funds being deposited into the account. Seeing repetitive deposits of a certain amount and cadence can provide a level of comfort that the funds will be there on a specific day, thus minimizing the risk to the institution. The innovation here is in the analytics that identifies the customers that would benefit from such a product and determines when and where this makes sense.
Orchestrating Customer Intelligence and Product Innovation. Now that customer intelligence and data collection have been prioritized and innovation solutions are being developed, it will be important to combine the two into tangible customer improvements. Solutions like virtual agents, next-generation chatbots, and true omnichannel engagement can result from successful implementations of new products built on top of modern architecture. Having an agile environment in place will continue to foster innovation and improve overall efficiencies.
Growing Role of AI. AI solutions in financial services have begun to evolve way beyond robotic process automation and have reached the level of providing true value back to the customer and the financial institution’s employees. AI can be used to monitor text, voice, sentiment, and emotion in a way that can deliver that empathetic experience many individuals are looking for from their institution. AI solutions will not only engage with the customer directly but can identify and reimagine legacy workflows and create improved processes.

Providing a truly hyper-personalized and empathetic banking experience will require that we truly put the customer in the center of everything and view products and services not through the lens of the financial institution, but rather through the lens of the customer. To build trust, we need to think less about providing financial transactions and more about helping customers achieve their financial goals. We also need to provide employees with the same level of modernized solutions and interfaces that we provide to customers, which will create that common and fulfilling experiences.

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Interested in learning more about empathy in financial services? Download this insightful, custom POV to understand how to adjust your technology strategy to meet the changing digital-first expectations of your customers. Or, check out this infographic that explores 4 Keys to Delivering Empathy in Financial Services.

These Women Are Driving Innovation at Smart Communications

Posted on March 8, 2022 by SmartComm

By: Jo Sweet, Chief Human Resources Officer at Smart Communications

As Group HR Director for Smart Communications, I have the privilege of encouraging a diverse group of people to be the best they can be. Supporting our global team and cultivating a culture that provides the best service to our customers is immensely rewarding. I believe that when people work together toward a common goal—like strategically solving complex business challenges for a number of industries—it promotes both career and personal growth.

When this growth is encouraged throughout the business, it can spark enthusiasm and drive long-term innovation from every employee whether individually or collectively with their teams.

At Smart Communications, we believe that building and nurturing a rewarding employee experience positively impacts our business and, most importantly, our customers’ experiences. We especially strive to create an inclusive workplace, so on this International Women’s Day, we are spotlighting some of the women in our business who drive innovation day-in and day-out:

Sally Schulte, Product Marketing Director, Atlanta, Ga.

What does your role at Smart Communications entail?

As the Product Marketing Director, it is my responsibility to educate existing and prospective customers as well as industry analysts about our most recent software enhancements and product roadmap This means collaborating internally with nearly every part of our organization – from web design, content development and demand generation to pre-sales, solution architects, customer support and product development.

What’s your favorite thing about working at Smart Communications?

The people. I’ve been very fortunate to work for some wonderful companies, some with enormous workforces. The professionalism and skillset of the people here continue to impress me, especially for a mid-sized company. Smart Communications has assembled a team comprised of true experts in their respective roles, which helps us all rise to the occasion and perform at a higher level.

What’s been something you’ve learned as a woman in tech that you want to share?

If you’re changing industries and coming to tech or just starting out, take the time to dive deep into the software and technology to better understand how it works at a user level rather than only focusing on the high-level benefits. This will help you tremendously as you engage with a diverse set of stakeholders.

Debbie Andrews, VP Sales North America, Jupiter, Fla.

What does your role at Smart Communications entail?

I am a leader within the North American sales organization, primarily focusing on our SmartIQ solution and healthcare industry vertical.

What are you up to when you’re not at your desk?

Spending time with my family. I have four children, all in the entertainment world and I am their “momager” of sorts. I read their scripts, books and treatments (lots of zombies and vampires). My favorite thing to do is to listen to their stories–their world is so different than when I was in my 20s. My husband and I like to travel and cook. This works well as we visit our children in Los Angeles and Virginia.

What’s your favorite thing about working at Smart Communications?

The culture. The people are so positive and engaging. Everyone is rowing in the same direction and working to make a difference.

What’s been something you’ve learned as a woman in tech that you want to share?

Be yourself. Women have unique viewpoints because of the way we process information, and it lends itself to our ability to have new approaches to business challenges.

Mina Smolej, Head of Demand Generation, DACH, Munich, Germany

What does your role at Smart Communications entail?

Generating interest in our product throughout the DACH region using programs such as advertising, events, account-based marketing and more.

What skills have helped you grow in this role?

For demand and lead generation, it’s key to be analytical. I’m not afraid of numbers – I use them to make informed decisions every day!

I’m results-driven. I track campaign performance daily to keep a pulse on what’s working and where we can improve.

I also think I am pragmatic and recognize that striving for perfection can sometimes hinder innovation and execution. Sometimes you need to pilot a campaign and then optimize based on performance.

What are you up to when you’re not at your desk?

I like hiking. I try to be in the mountains two times per month. I also like cooking. I try a new recipe every week. A recent favorite was a dish with fusilli pasta, spinach, walnuts, chickpeas and eggplant. And, I like reading. I love that moment when you get a perfect book and after the first chapter, you’re hooked.

What’s been something you’ve learned as a woman in tech that you want to share?

Believe in yourself, work to grow your skills and everything else will happen. If a company doesn’t recognize your contributions, it is probably not the right company for you.

Saliha Karaman, Senior Customer Success Manager, Sydney, Australia

What does your role at Smart Communications entail?

I am responsible for developing strong customer relationships and ensuring our customers are achieving success using Smart Communications solutions and services.

What are you up to when you’re not at your desk?

When not at my desk, my pandemic-compatible hobbies have included becoming best buddies with Netflix, stimulating the mind with a great book and working on perfecting the perfect dumpling recipe.

What’s been something you’ve learned as a woman in tech that you want to share?

Something I’ve learned as a woman in tech is that being a woman is not a barrier to success. With the right support and leadership, women are empowered to achieve their dreams. I feel lucky to be part of a culture where fantastic female professionals are recognized and celebrated.

Courtney Richmond, Senior Legal Counsel, CIPP/E, London, England

What does your role at Smart Communications entail?

My role is diverse and interesting as on any given day, I’m working proactively on the creation and negotiation of a broad range of commercial agreements and/or serving as a primary advisor on global data protection and privacy across the business. I also collaborate cross-functionally with sales, customer support, product, engineering, finance and other departments to provide both strategic and legal direction on the development of new business opportunities.

What are you up to when you’re not at your desk?

I love being active and outdoors whether it be running, walking, cycling or swimming.

What’s your favorite thing about working at Smart Communications?

I love working with the Smart Communications team. No day is ever the same and I love the problem-solving element each day brings.

What’s been something you’ve learned as a woman in tech that you want to share?

I think it’s so important that you play to your strengths as a woman. Women bring diversity and a valuable perspective to the table.

Like what you’ve read about working at Smart Communications?

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Omnichannel vs. Multichannel Experiences: Who is at the Center of Your Universe?

Posted on March 1, 2022 by SmartComm

By: Chris Murphy, VP Product Marketing at Smart Communications

In 1543, Nicolaus Copernicus published a crazy theory he had been working on for over 30 years. He proposed that the Sun was the center of the universe. Why was this considered crazy? Because the prevailing wisdom of the day was that it was the Earth, not the Sun, that everything revolved around. And while that difference may not seem massive to us today, at the time, the “Copernican Revolution” propelled scientific thinking forward, influencing thinkers from Galileo to Isaac Newton.

At this point, it’s fair to ask – what does this have to do with omnichannel vs. multichannel customer experiences? As the title of this post suggests, it’s really all about deciding at a strategic level: who is at the center of your universe? You, or your customer?

This post will examine the key differences between omnichannel and multichannel customer conversations, revealing the best strategy for leading enterprises going forward. And if you find this discussion interesting, you’ll want to review our ebook, The Omnichannel Advantage, which provides even more insights.

Because every customer interaction is an opportunity to shape their overall experience, there is more pressure on enterprises than ever to orchestrate interactive, two-way conversations. As we review omnichannel vs. multichannel experiences below, you will uncover the benefits of omnichannel conversations and why this approach delivers more engaging, personalized customer interactions.

Multichannel Approach: Your Business at the Center

Just as with thinking that everything revolved around the Earth, a multichannel customer communications strategy starts with a somewhat business-first (opposed to customer-first) approach. In most instances, a business has something it wants or needs to communicate out to customers, whether that’s marketing messages, transactional notifications or responses to individual customer queries.

It’s pretty simple and straightforward. Messages are distributed out by the company, and customers separately reach out with questions. Unfortunately, both are one-way streets and the customer is caught watching from the sidelines. This approach also assumes that customers fall neatly into a single channel – whether that’s “email customers” or “print customers.” Unfortunately, that’s not the reality we live in. Today’s customer moves between channels throughout their journey with a company and expects interactions to carry over seamlessly from one channel to the next.

In a multichannel approach, there are disadvantages that affect some of the most important aspects of the customer experience. When the business is at the center, communications often are missing personalization, mostly because the business may lack the data and technology infrastructure needed to execute on individualized interactions.

Ultimately – and perhaps most importantly – a multichannel communications strategy severely limits how and where a customer can interact with a business. This approach makes it very difficult for customers to initiate conversations from their preferred channels because the business is at the center.

Omnichannel Approach: The Customer is the Center

An omnichannel customer communications strategy represents a paradigm shift as big as the one Copernicus set forth. While every business claims the customer is the center of all they do, the ones who organize their entire communications processes and infrastructure around the customer prove that they mean it.

With an omnichannel approach, every touchpoint leads to a carefully curated experience. Every interaction has the potential to be a two-way conversation, and each touchpoint builds off the previous one. Omnichannel conversations provide the right information at the right time in ways that are easy to understand and act upon.

And while there are still many channels in an omnichannel approach, they’re all connected, scalable and centrally managed – and customers can move effortlessly from one channel to another. In a word, communications are orchestrated across all these channels.

In a multichannel approach, the goal is often to simply add more channels. In reality, however, it’s much more important to deliver a quality and connected experience across channels. So, it’s about how well the channels work together, not necessarily how many there are. With a powerful customer conversations platform, enterprises ensure consistent, compliant communications across brands and geographies on whichever channel the customer prefers.

And when it comes to personalization, omnichannel communications outshine multichannel here yet again. Because the customer is in the center, everything is designed around them. With the right technology partner, it’s easy to collect information from the customer in an engaging way that can then be used to shape the rest of their communications experience. When they express a channel preference for specific communication types, it’s easy to put that into practice. If it changes, it’s easy to update. Omnichannel conversations offer the possibility for truly personalized interactions that are contextually based on every other step they’ve taken – across channels and devices.

It’s important to keep in mind that as a customer moves from channel to channel, context is key. Understanding the context of specific interactions is important and further emphasizes the importance of personalization. Getting context right lends itself to ensuring a company is choosing the right content – the right tone, the right language, the right sentiment – to deliver an amazing customer experience.

An omnichannel approach also helps strike the balance between managing customer support across time zones and allowing for self-service options. As chatbots and other interactive technologies become more sophisticated, a strong technology foundation will be more important than ever to ensure customer needs and expectations are met.

Dive Deeper

It’s clear that omnichannel conversations are the path forward for leading companies, but getting it right requires the proper technology. For a more in-depth look at omnichannel vs. multichannel experiences, strategies and information on how Smart Communications can help, we invite you to download our ebook, The Omnichannel Advantage.

For Life Insurers, A Scalable Approach to New Business

Posted on February 8, 2022 by SmartComm

By: Ruth Fisk, VP Insurance Marketing at Smart Communications

The life insurance industry as a whole has been slow to adopt new technologies, but recently has had to place more of a focus – and investment – on digital-first customer experiences. The global pandemic forced many life insurers to condense multiyear digital transformation strategies into a short timeframe. The industry is now at an inflection point where they should refine and tweak the processes that were implemented quickly to ensure they are secure and built to scale, as well as identify new ways to innovate for the future.

Today, many customers not only expect a more fluid experience, but also the ability to purchase multiple products at once, including life insurance, long-term care coverage and/or disability coverage, for example. With innovative products emerging to reflect shifting customer behaviors, there is no better time for life insurers to rethink processes surrounding new business.

The siloed technology stacks of the past lead to internal inefficiencies, compliance risks and an inconsistent, disjointed customer experience. However, every interaction an insurer has with a customer is an opportunity to shape the overall experience – and the multiple touchpoints throughout acquisition, onboarding and policy issuance must be automated and optimized.

In the infographic below, we provide life insurers with one view of all of the unique interactions that span across the entire new business process. We also highlight how a modern customer communications platform like the Smart Communications Conversation Cloud^TM enables life insurers to seamlessly work throughout the new business process.

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SmartDX

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Healthcare Payers

Healthcare Providers

Government

Utility

Resource Center

Customer Resources

Events

News

About us

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Analysts

SmartCOMM

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Insurance

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Customer Communications for Medicare Advantage Plan Enrollment is Ripe for Transformation

Cloud-based Customer Communications Software Enhances Medicare Member Experience

The Importance of Star Ratings and How CCM Software Can Help Medicare Member Engagement

Annual Notice of Change (ANOC)

Evidence of Coverage (EOC)

Provider Directory

Pharmacy Directory

Drug Formulary

Explanation of Benefits (EOB)

Appeals and Grievances

Moving Medicare Advantage Communications to the Cloud

If you’d like to learn more about how to member engagement, visit our Medicare Advantage page.

1. Use Low-Code Solutions to Eliminate Manual Forms

2. Improve the Healthcare Member Experience with SMARTER Conversations

3. Enable Intelligent Conversations for Claims Appeals

4. Automate the Healthcare Forms Process with Cloud Technology

Improved healthcare member experience

Increased efficiency throughout the claims process

Lower regulatory risk

Conclusion

To discover how low-code solutions can help health insurers boost member engagement, access our on-demand webinar to see SmartIQ in action. Or, request a demo for more information about how payers can benefit from the SmartIQ solution.

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