As a result of healthcare reform and mandated individual coverage, health payers seek to know their individual customers more intimately than ever before. Customer experience is loosely defined as the sum of all interactions and experience a customer has with an insurer throughout their relationship. Interactions can come through multiple channels: Internet, phone, fax, email, chat or more. Having the right systems and data at customer channels and touchpoints is key to enhancing customer experience.
Capgemini’s one stop, comprehensive solution for customer experience for health payers utilizes Pega’s Customer Process Manager for Healthcare and Care Management Framework to gain a 360° view of provider and member information; manage member cases through a single and unified member case management tool; and create a personalized medicine workstation to efficiently manage clinical testing opportunities from start to finish.