Lighting the Path in the Golden Age of Government-Sponsored Health Programs: Join Us for the GHG Client Forum
More than 300 guests will convene on May 1-2 at the Red Rock Casino in Las Vegas for the 2014 Gorman Health Group Forum, our annual strategic retreat for leaders in government-sponsored health programs. This year's gathering promises to be the most actionable, content-packed conference you could attend on how to succeed in this new Golden Age of government business. And when the learning and planning is done for the day, we will celebrate this unique moment in health care history as only GHG can in Vegas. Here's what's happening this year and why you've got to join us:
- The event features 27 content-charged sessions, including multiple presentations on Star Ratings tactics, quality improvement, risk adjustment, and compliance challenges unique to Medicare Advantage and Part D, Medicaid, and the ObamaCare exchanges
- A keynote presentation from CMS leadership
- An expert roster of presenters from Gorman Health Group and leading health plans in government-sponsored programs. No fluff, no sales pitches, no history lessons -- it's all about what to do NOW
- Approved for up to 12 continuing education credits from the Compliance Certification Board
- The perfect off-the-strip venue to minimize distractions during the day, but close enough to the action to make plenty of bad decisions in the evenings. ;)
Based on feedback from last year's Forum, I'm speaking in three separate sessions on overall strategy and implementation planning for government programs. If you've heard my "state of the industry" presentation before, you may think you know what to expect from me on stage. Think again. This is my favorite gathering of the year, and I'm building three brand-spankin' new presentations that are focused on specific steps and mileposts your organization needs to reach this year in care management innovation, risk adjustment, Star Ratings, and operational performance improvement. In each session I'll drill down to specific steps, and we'll leave you with a self-assessment tool in our closing session to help track your progress.
Many of our clients use the Forum as an offsite retreat for their government programs executive teams, and so we offer huge group discounts to encourage it. It's a unique opportunity for team-building and action-oriented planning and budgeting.
If government-sponsored health programs are central to your company's future, do yourself a favor and join us in Vegas. You'll come back tired, happy, and ready to win in this crazy new environment of health reform.
Don't believe me? Hear what last year's attendees thought about the event, and why they keep coming back for more.
Resources
Register today for The Annual GHG Forum held May 1-2 at the Red Rock Casino and Resort in Las Vegas. This two day event is designed to provide best practices for the decision makers of organizations serving Medicare members, Exchange beneficiaries, and the Dual eligible population.
On April 11, Bill MacBain and Jean LeMasurier will be back, and this time joined by John Gorman, Executive Chairman of GHG, to offer insight on the Final Rate Announcement from CMS. You will walk away from this session with critical to-do items and issues to tackle in order to ensure your success in 2015 and beyond. Register now >>
Navigators and Agents Gone Wild
Since the October 1 launch of the ObamaCare health insurance exchanges/marketplaces, there's been a growing din over the field conduct of navigators and insurance agents, in the process of enrolling eligibles on behalf of the exchanges or the health plans participating in them. Meanwhile, the associations backing brokers are putting pressure on the Obama administration, insisting that brokers should be more involved in the enrollment process. Add a regulatory infrastructure that is lax — at best — when it comes to training and enforcement … does anyone else have a sense of déjà vu? It's the market conduct growing pains of the Part D inception all over again. There is no doubt that some of the "navigators and agents gone wild" stories out there are simply anecdotal rumor mill reports coming from enterprising local reporters, or are "stings" by conservative bloggers and activists scoring cheap anti-reform points.
But it's also true that navigator and broker involvement has been controversial since the inception of ObamaCare. You likely remember that in the early versions of the ObamaCare laws, that brokers were not even in the picture and Republicans have made great political hay so far of the navigators as the healthcare equivalent of ACORN. Over 100 community organizations in 34 states won $64 million in Federal grants to field thousands of outreach workers to find and help enroll the uninsured, and they've been hounded mercilessly by Congressional oversight committees, local reporters and ObamaCare dead-enders. Even the most well-intentioned brokers and navigators have had a rough go of it during these first two months. Here's the harsh reality: Brokers face a backlog of enrollees who, for one reason or another, have not been able to submit their application. And the current flood of beneficiaries out there stuck in the application process are overrunning the system — there isn't enough time left to process them all, ESPECIALLY when you take into account the difficulty brokers have helping consumers who are already halfway through the process before they ask for help.
To add insult to injury: Because of insufficient training, many brokers weren't prepared for how this would play out. It wasn't until they encountered real problems, sitting next to their real clients, that the lack of training and preparation made itself painfully clear. The deck is stacked against the broker community here, and the media spotlight will continue to get hotter.
For health plans using brokers to distribute their products in the exchanges, there is very little chance that it can or will be done effectively. Every plan's goal is to understand and have some degree of control over how the brokers are representing the brand and the products in the field. But the huge influx of brokers into the process, very little training beyond the bare minimum required by the feds, no guidance from CMS on broker conduct, and the enrollment portal problems --- can oversight of these agents even be on the radar?
It's all so reminiscent of the perfect storm of sales misconduct during the launch of Medicare Advantage and Part D. In 2007 and 2008 Congress held several hearings where witnesses testified that sales agents had marketed without licenses, portrayed themselves as Medicare employees, and misled Medicare beneficiaries about plan benefits. Some of these events were a simple matter of insufficient training or understanding of the implications of their behavior, which we are ripe to experience in the exchanges. Others were blatant fraud. Congress's response to these incidents was the enactment of the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA), which prohibited or limited certain marketing activities by sales agents and plan sponsors, required that all sales agents be trained and tested annually, and be State licensed, among other things. Plans responded by adopting leading-edge solutions like GHG's Sales Sentinel (now covering over 55,000 agents in Medicare and the exchanges) to help them onboard, manage and oversee their brokers and agents in the field. In the exchange world, the biggest risk of all of the mayhem is a health plan's reputation -- which we've seen shattered by agent misconduct in the past. And the biggest counter balance initiative is for plans to blaze the trails when it comes to providing field agents sufficient guidance and training on conduct and repercussions, until CMS and the states catch up.
Resources
GHG's Sales Sentinel is the only sales oversight tool designed specifically for health care organizations operating in regulated government markets. To learn how Sales Sentinel can help your organizations agent onboarding and ongoing oversight process, visit our website >>
During the 2013 GHG Forum, Executive Chairman & Founder John Gorman, discusses how important it is to successfully train, on-board and conduct ongoing agent oversight for your Plan's success. Click here to access the recording>>
Listen as Senior Director of Product Operations at Gorman Health Group, Alex Keltner discusses GHG's Sales Sentinel, the solution to train, credential and onboard your sales force. Access the podcast here >>
Join us December 11 from 2:00 — 3:30 pm ET for a lively session with Gorman Health Group strategy and data analysis experts who will discuss actual case studies that show how plans can mine data for precious insight that can help improve performance. Register now >>
Pay me now or pay me later: Things to keep in mind when you set your 2014 budget
Back in the '80's Fram Oil Filters had an advertising campaign that featured an actor dressed as a mechanic, admonishing viewers to get their oil changed and get a new oil filter, to prevent costly engine damage. "Pay me now or pay me later," he said.
When it comes to some key Medicare Advantage functions, the "pay me later" scenario can be perilous indeed.
Take data reconciliation, for instance. MA plans, especially those with drug coverage, need to reconcile at least a dozen different types of data with CMS: Enrollment data; Transaction reply reports; Retro processing contractor; Beneficiary churn ; Capitation payments; Premium data; Out-of-area residence; Subsidy payments; Medicare as secondary payer; Prescription claim (PDE) data resolution; Part D coordination of benefits (COB); Enrollment data validation; Compliance & reporting; Medicaid state roster and best available evidence of Medicaid enrollment.
The sheer volume of data and transactions dictates use of automated processes and controls to manage the reconciliation workflow. Spreadsheets won't cut it, and quasi-manual processes rapidly fall behind the need for daily data import and analysis. Failure to reconcile results in incorrect claim and capitation payments, premium collection issues, enrollment and benefit errors, reduced quality scores, and the potential for excess repayment under drug plan risk corridor reconciliations. Even for small plans, there can be millions of dollars at stake.
Compliance is another area where failure to invest in automated systems now can cause a bad "pay me later" outcome. The cost of a bad CMS compliance audit isn't just the staff time to correct problems. Most compliance problems are directly linked to member satisfaction issues, and a "bad" audit is symptom of deeper problems that lead to high member services call volume and disenrollment rates. Not only does CMS expect plans to be audit ready all the time, members expect things to go right all the time. We have found that the best approach is to use information technology tools to continually monitor compliance at the department level, to maintain complete and organized documentation, and to identify areas where compliance is lagging — where management intervention is warranted. Compliance programs need to be documented, regimented and sustainable. Compliance doesn't wait to happen. It takes an organized and on-going campaign, supported by automated tools to remind, track, document, and spotlight problems.
A third opportunity for trouble is in how sales agents are trained, vetted, and monitored. CMS requires annual training, which is best done using computer-based learning systems. Embedded testing provides documentation of comprehension. On-going supervision requires diligent tracking of complaints and allegations to confirm, respond, and assess improvement. As with other complex tasks, an automated solution reduces opportunities for errors and omissions.
At a time when every dollar counts, it's a good idea to consider budgeting for an investment in software solutions that solve these problems. Gorman Health Group has built software that supports our own consultants as they work with health plans on these issues, and these tools are available for health plans to use in their own operations. The GHG software is unique in that all of these applications are Web-based, fully hosted solutions that present no strain to IT resources. And GHG's subject matter expertise drives each product's unique functionality.
I invite you to contact my colleague RaeAnn Grossman, to start a conversation about your goals, the risks you face, and your available resources and budget for the 2014 year.
RaeAnn Grossman
Chief Sales and Marketing Officer
Rgrossman@ghgadvisors.com
Resources
Decision-makers from Health Plans and Provider Organizations are invited to join GHG for a free webinar on November 19th: "The future of the Government sponsored health care." Register for this free event now >>
The Online Monitoring ToolTM (OMTTM) is a complete compliance toolkit designed to help organizations track the compliance of their operations. Visit our website to learn more about how the OMT can help your organization >>
The way in which you onboard, train and conduct ongoing oversight on your sales agents is critical. GHG created Sales Sentinel™ specifically to meet the needs of health care organizations operating in regulated government markets. Learn more here >>
Every health care organization is looking for improved outcomes, better compliance and enhanced process efficiency when it comes to managing membership and premium payments. GHG's Valencia was designed specifically to meet those needs.
Agent Oversight Opportunities
The leaves will soon be changing, a sign of renewal. It sounds cliche, but I don't know where this year has gone. There has not been much opportunity to stop and smell the roses while they were still in bloom! CMS has been busy and so have we.
I had the pleasure of addressing a group of compensation experts representing quite a few Blues plans in the very hospitable city of Jacksonville, Florida last week. I would link to the conference or the materials, but most likely it is hidden from us in the uber-exclusive BlueWeb extranet of the BCBSA. Many thanks to Glen Ross and company for having us!
Agent Oversight was my topic of choice, since AEP is coming as quickly as those leaves will be changing. Plan Sponsors are deep into marketing strategies, material preparation and (hopefully) systems updates and re-training to gear up for what hopes to be a successful AEP. I addressed two areas of agent oversight and provided some guidance and best practices for some common misses.
The first opportunity addressed pertained to Outbound Enrollment Verification, or OEV. You wouldn't believe what a hotbed this is for unnecessary beneficiary cancellations. Many call center representatives are not always asking the additional questions to determine if their script information doesn't jive with what a sales agent told a beneficiary. For example, the CMS model script makes no mention of Low Income Subsidy nor how it would affect a potential member's out-of-pocket costs. I provided quite a few recommendations and best practices to the group, including the recommendation to customize the model script and submit for 45-day review, and to have sales staff provide OEV information after the enrollment form is completed. The beneficiary should know what the next step is in the process, and there's nothing like a heads-up about the next phone call from the health plan to reenforce the commitment to member-centric service.
The next area of opportunity pertains to some common misses in the sales allegation investigation process. A comprehensive investigation is not only reactive to allegations, but it also incorporates proactive steps to reduce future occurrences of the same issue. Lack of documentation is at the heart of some common failures. We've seen at times there is no one central repository for investigation notes. Interviews are not conducted in a timely manner, which begs the question, where do sales allegations fall on a priority list? We know there's a ton of work to be done to maintain agent information to ensure they are appointed appropriately; we handle it in Sales Sentinel. However, the relationship with the agent is an ongoing process. Plan Sponsors should communicate to agents that allegations are going to be a part of doing business. The sky will not fall upon receipt of one. What matters most is the outcome of that investigation, and taking steps to ensure future occurrences are avoided.
Regional Offices are keeping a close eye on outlier plans by reviewing calls to 1-800-MEDICARE, aka Complaint Tracking Module (CTM) calls. Not only are they looking for outliers in overall CTM volume, but they are reviewing percentages of marketing misrepresentation cases within. If they are appearing there, most likely they are appearing in Customer Service inquiries and not being identified and handled as grievances. My presentation on these two opportunities for oversight, as well as best practices, can be found here on the Point. Not a member yet? Sign up here or contact us for group rates.
Resources
We created Sales Sentinel™ specifically to meet the needs of health care organizations operating in regulated government markets. Whether you operate within MA or the new Health Insurance Marketplaces (the Exchanges), Sales Sentinel offers a suite of solutions.
Listen as Senior Director of Product Operations at Gorman Health Group, Alex Keltner discusses GHG's Sales Sentinel, the solution to train, credential and onboard your sales force.
Bloom Marketing Group's call center is licensed in 48 contiguous states and offers marketing, call center and technology solutions to the healthcare industry. Bloom is a proud partner of Gorman Health Group, click here to learn more.
Call Center Metrics Reporting Should Be Robust and Actionable
Metrics reporting is as important to insurance call centers as the Law of Large numbers is to an actuary. Call centers use metrics reporting on sales and marketing campaigns to measure individual agent performance, track campaign results and more.
Sales and marketing metrics reporting should be robust and dynamic because you can't manage what you can't measure. Dynamic reports should cover all required CMS call center metrics as well as standard call center Key Performance Indicators (KPIs), call dispositions and marketing metrics at the individual toll-free number level. This in-depth reporting creates a true measure of cost per response, cost per lead, and cost per sale.
No matter how robust the reporting however, metrics are useless if they are not actionable. At minimum standard reports should include key performance indicators that allow you to take action. Examples include:
- Abandonment Rate, Drop Rate — length of time caller waited before they abandoned the call and the percentage of overall calls that were dropped. Look at these numbers daily at a minimum and ensure your call center is not missing opportunities through abandoned and dropped calls.
- Average Handle Time, Wrap-Up Time — the average time an agent spent with a caller during the call and in "wrapping up." Make sure your call center Managers are examining these items closely and coaching team members who fall outside the norms on these metrics to keep your center working at peak efficiency. Look for opportunities to streamline your processes in these metrics, too.
- Average Time in Queue — the average time callers waited before being connected to an agent. Look at this metric daily and in aggregate to ensure you aren't losing opportunities with your callers by keeping them on hold.
- Disposition Reporting — a summary of what happened on the call such as "Enrolled" or "Mailed Materials." Examine these closely daily and in aggregate to gain insight into the overall campaign outcomes.
- Quality Reporting — how agents scored on each call based on a client's metrics and/or metrics created by the call center. Bloom uses a minimum of 13 variables plus 9 pass/fail compliance variables when grading agent performance. Look at these reports individually and collectively to identify gaps in caller understanding, opportunities for training, and occasions for scripting improvement.
Are the reporting metrics received from your call center clear and actionable?
Resources
The Bloom Call Center is licensed in 48 contiguous states and offers marketing, call center and technology solutions to the health care industry. Since 2007, Bloom has participated in over 55 million conversations about insurance products, submitted over 200,000 applications for insurance, and set over 150,000 appointments for seniors to meet with Licensed Agents. Bloom is a proud partner of Gorman Health Group. Click here to learn more.
A Good Script Doesn't Sound Scripted
American film director Steven Spielberg once admitted that the only thing that gets him back to directing is good scripts. Good scripts help give a film structure, purpose and clarity. Good scripts are important in the insurance call center industry, too!
A well developed script should do more than comply with the rigors of regulatory compliance, however. A good script should engage callers, encourage rapport, capture key data and provide a path for closing sales or retaining members. So how does a call center successfully do all that?
- Explore the uniqueness of a company's products and processes prior to developing a script. Once identified, use those features as the cornerstone of the script and help direct the caller to the desired conclusion.
- Close collaboration is Key Collaboration is an important skill requiring effort from all parties, especially when communicating the complexities of health care choice. Collaboration with a proven script writing partner whose stable of experienced sales agents help execute the script is a big step towards a successful partnership. Additionally, ensuring all call center teams speak with the same voice is essential.
- Flexibility during the script writing process is essential Needs and demands often change during a sales and marketing campaign. It is important that all participants remain open to change as the process unfolds and different departments vet the script. Make sure you are using a script that allows for campaign flexibility while still meeting regulatory requirements and best practices. This is particularly important to all in the healthcare industry on the advent of the Affordable Care Act (ACA).
Remember, a successful script creates caller interest, provides the capturing of important data and offers a clear route to closing the sale. In short, a good script doesn't sound…scripted.
Resources
The Bloom Call Center is licensed in 48 contiguous states and offers marketing, call center and technology solutions to the health care industry. Since 2007, Bloom has participated in over 55 million conversations about insurance products, submitted over 200,000 applications for insurance, and set over 150,000 appointments for seniors to meet with Licensed Agents. Bloom is a proud partner of Gorman Health Group. Click here to learn more.
GHG's Software Sales Sentinel™ Achieves 97% Renewal
Gorman Health Group (GHG), is proud to announce that its software, Sales Sentinel™ has achieved a 97% renewal rate, never having lost a client due to performance or dissatisfaction.
Sales Sentinel™ supports more than 30 health plan clients across the U.S. and trains more than 30,000 agents each year. Already in 2014, Sales Sentinel™ has 33 clients on board, four of which are among the top 10 largest health care carriers in the US.
This software facilitates sales agent onboarding, credentialing and ongoing oversight, and it eliminates the labor-intensive agent onboarding process for both your Exchange and Medicare Advantage businesses.
To learn more about the software and its benefits, listen as Senior Director of Product Operations at Gorman Health Group, Alex Keltner discusses GHG's software solution to train, credential and onboard your sales force in a podcast on the Point.
Resources:
Learn more about GHG's software, Sales Sentinel™ in a free download available now on the Point >>
Simplfiy sales agent oversight with Gorman Health Group's software solution designed for health care organizations operating in regulated government markets. View a short video of the software tool available now.
Ensure you are audit ready, all the time. Learn the benefits of Sales Sentinel here >>
GHG named the Blue Cross and Blue Shield Association's national sourcing partner for onboarding, credentialing and conducting ongoing oversight for your sales force. Read more here >>
GHG Announces New Partnership With BCBSA
Gorman Health Group (GHG), is proud to have been selected as a National Partner with the Blue Cross and Blue Shield Association (BCBSA) for its software, Sales Sentinel™. This software facilitates sales agent onboarding, credentialing and ongoing oversight, and it eliminates the labor-intensive agent onboarding process for both your Exchange and Medicare Advantage businesses.
Learn more about the partnership in our latest podcast on the Point recorded by Whitney St. Jean , Chief Administrative Officer at Gorman Health Group. In this podcast Whitney discusses what particular areas and benefits will be included in our relationship as national partner with BCBSA.
Download the free podcast here >>
Resources:
Gain more information on the nature of the BCBSA partnership for GHG's software, Sales Sentinel™ in a free download available on the Point now >>
Simplfiy sales agent oversight with Gorman Health Group's software solution designed for health care organizations operating in regulated government markets. View a short video of the software tool available now.
The ObamaCare Enrollment Push Begins
So we're less than 100 days away from the official launch of outreach and marketing for the new Health Insurance Exchanges, and the enrollment push began in earnest this weekend. It's happening in the face of some tremendous headwinds unlike anything seen since the launch of Medicare Part D in 2006, maybe ever. The Medicare drug benefit' s takeoff didn't have to contend with furious political opposition at both state and Federal levels, a horribly misinformed public, and the demographic challenges of ObamaCare.
Enroll America, the Obama-driven leftie coalition that's tasked with pushing enrollment in the exchanges, kicked off its boots-on-the-ground effort last week. Enroll America President Anne Filipic told POLITICO today that the first week went well as the group tried to change the conversation from politics to benefits. They had 1,000 volunteers out, 1,000 on a strategy call, 78 events in 25 states (they expected to do 50 in week one), and knocked on 3,200 doors. Not a bad start for a group that sprung from Obama's legendary campaign ground operation.
Changing the debate from politics to benefits is no small task for the pro-ObamaCare forces in the field. Health and Human Services Secretary Kathleen Sebelius has been getting slammed for her fundraising calls on behalf of Enroll America to industry stakeholders like insurance companies. Last week 28 GOP senators sent a letter to HHS Secretary Kathleen Sebelius asking her to "immediately stop" fundraising for Enroll America until she has answered more questions about it.
Then Sebelius called all the professional sports leagues last week to seek their help in outreach to potential ObamaCare beneficiaries this fall -- and Congressional Republicans wailed again. Senator Minority Leader Mitch McConnell (R-KY) and Senator John Cornyn (R-TX) wrote "Given the divisiveness and persistent unpopularity of the health care [law], it is difficult to understand why an organization like yours would risk damaging its inclusive and apolitical brand by lending its name to its promotion," in letters sent to the commissioners of the NFL, MLB, NBA, NHL, PGA and NASCAR. It appears most if not all of professional sports will not participate. It's too bad -- I loved the speculation of what the ads might look like.
All of this is of course happening against a backdrop of a terribly misinformed public, especially among uninsured prospective ObamaCare beneficiaries. An April Kaiser health tracking poll found 42% of Americans are unaware that the Affordable Care Act (ACA) is still the law of the land, including 12% who believe the law has been repealed by Congress, 7% who believe it has been overturned by the Supreme Court, and 23% who don't know whether or not the ACA remains law. And about half the public says they do not have enough information about the health reform law to understand how it will impact their own family, a share that rises among the uninsured and low-income households.
The biggest problem the ObamaCare rollout faces, though, is demographic. First, many ObamaCare eligibles are low-income, and not necessarily English-speaking. They may not see or understand ads on English TV channels this fall, and they'll need different messaging, outreach and hand-on counseling at the kitchen table. And with Congress literally appropriating 10% of what the Administration requested for insurance Navigators to help the uninsured through the enrollment process, and literally dozens of Red State governors in opposition and of no help on the ground, that's a tall order for Year One. CuidadoDeSalud.gov is getting a makeover this summer, and HHS announced it has opened its 24/7 call center, which is supposed to be able to handle millions of consumers' questions in 150 languages.
Second, the viability of the exchanges rests on risk selection, and that means if we don't get the "young invincibles" and the "bro's" to sign up to offset the risk of the sick uninsured we know will flock to the program, we'll fall into a rate-setting death spiral. The Administration is looking for 7 million enrollees in Year One, including 2.7 million young adults. And there's actually some encouraging news here: Kaiser's poll found more than 70% of those under 30 said that having health insurance is "very important," something they need, and that it's worth the money. Overall, just a quarter of those ages 18-30 feel they are healthy enough to go without insurance. Doesn't necessarily mean assured enrollment, but it is a ray of hope through all the white noise.
Things are sure to get Presidential campaign-level crazy right after Labor Day, when the Administration is convinced folks will start paying attention. Expect a blizzard of pro and con communications across every medium imaginable, and millions of confused uninsured consumers in between.
Resources
Read Gorman Health Group's recap of the 2013 GHG Forum, which includes details regarding preparing for the health insurance exchanges. This free download is available on the Point.
Listen to a GHG podcast from GHG's Executive Vice President Steve Balcerzak regarding the unbanked and the uninsured, and the implications this population will have on ACA enrollment. This podcast is freely available on the Point.
GHG policy expert Jean LeMasurier provides an overview of key takeaways from CMS' proposed rule that establishes financial integrity and oversight standards for Health Insurance Marketplaces, QHPs in FFMs, and states that operate risk adjustment and reinsurance programs. This regulatory summary is available to members of the Point.
Agent Oversight Improves Quality and Customer Experience
If you're like most health plans, you rely on key "glue folks" to keep operations running smoothly. You know the ones: staff members that embrace their role, mind the details and ensure behind-the-scene efforts improve outcomes. They may or may not communicate one-on-one with customers, but their efforts contribute in a positive way to the overall customer experience.
For many, the partners and team members that manage the oversight of field and call center agents are the very glue of the sales and marketing activities inside a plan.
Consider agent oversight in three parts: Compliance, Operations and Quality. They're three distinct functions of equal importance. When synchronized, Agent Oversight aids in seamless performance of an organization's sales and marketing efforts.
What do we mean by three distinct functions? Consider the three-legged stool:
Compliance is more than a disciplinary function. The compliance department should work directly with Operations to ensure open channels of communication exist with all sales agents. Effective communication of regulatory requirements through training can mean prevention of compliance missteps and disciplinary actions.
Operations should be proactive regarding agent oversight functions. With careful monitoring of agents and frequent status reports, agent issues can be addressed promptly and directly. Simplify the process with technology to monitor sales meetings anywhere and anytime and assess agent performance in real time. Oversight recommendations may include additional training, corrective action or require immediate termination. Regardless the action, the result must be swift.
Quality programs should offer metrics on evaluating agent performance. There are a number of ways to rate agent performance in the development and implementation of Quality programs: grading, coaching or performance reporting. At Bloom, we use all of those tools — as well as call review, call scoring and calibration for each call center agent. Plans should work closely with their call center partner to develop, implement and assess a customized Quality program that best meets their needs. A strong partner can work with a plan to implement an existing program or to craft a new one.
Resources
The Bloom Call Center is licensed in 48 contiguous states and offers marketing, call center and technology solutions to the health care industry. Since 2007, Bloom has participated in over 55 million conversations about insurance products, submitted over 200,000 applications for insurance, and set over 150,000 appointments for seniors to meet with Licensed Agents. Bloom is a proud partner of Gorman Health Group. Click here to learn more.