These challenges were central to an executive session at Becker’s Fall Payer Issues Roundtable, where Greg McDavitt, MD, director for healthcare industry strategy at ServiceNow, led a discussion about the value of an enterprise-level service line model for the payer industry.
Three key takeaways were:
- Outdated and reactive processes bog down internal and external customer service lines. Dr. McDavitt highlighted a critical inefficiency in traditional helpdesk and customer service models: The current process, he said, typically involves manual searches through knowledge bases and across multiple application before routing requests to the appropriate team or individual. As a result, resolution can take an excessively long time, ranging from two to three days or as long as six weeks or more. This slow, fragmented approach creates significant delays in addressing member, provider and employee needs and wastes valuable organizational resources. The cost to address each inquiry and incident rises as more personnel are allocated to manage the rising workload.
- ServiceNow routes inquiries efficiently and streamlines services across business units.
Even if service requests requires orchestration between different systems of record, ServiceNow can unify those workflows, Dr. McDavitt said. It’s about operational cost reduction while still improving performance.
“It’s about embedding intelligence that looks into processes to see where they get stuck, looks for opportunities to automate steps and measures the impact of automation,” he said.
Within ServiceNow’s streamlining logic, there are also opportunities for leveraging predictive intelligence by classifying common issues tied to discrete business processes, and documentation intelligence by linking paper-based documentation such as faxes and paper forms to service requests.
- Payers are aiming for an enterprise service line model for complex problem-solving
Dr. McDavitt noted how payers are no longer simply interested in optimizing tier-one, customer-facing call centers but are looking for service solutions that can route complex inquiries throughout the enterprise. These types of inquiries usually correspond to high-cost, high-value, and high-volume operations.
“When payers transition to an enterprise service desk model, we’re seeing 25% improvement in turnaround time for all issues, including billing and claims, grievances and appeals, coordination of benefits, prior authorizations and general complaints,” Dr. McDavitt said.
