Should Health Insurance Agencies Just Record Calls or Do More?

To comply with Centers for Medicare & Medicaid Services (CMS) guidelines and carrier requirements, insurance agents must stay vigilant. The CMS Final Rule 2023 mandates the recording of all customer/prospect calls, making it a legal requirement rather than an optional practice. This means, all Medicare and Medicaid marketing calls, including interactions related to enrollment, must be recorded and stored for 10 years. The rule applies to healthcare field agents and professionals involved in enrolling beneficiaries in new Medicare Advantage and/or Part D plans. This includes individuals who engage in marketing and sales activities related to these programs.

Health insurance agencies must design a comprehensive call recording program, but it significantly affects their business costs, especially when they are drawing valuable insights from these recordings for quality assurance (QA) checks. But here is a problem. Despite employing experienced QA agents to analyze these calls, it is almost impossible to evaluate every call against carrier and CMS parameters. As a result, only a few sales enrollment calls  undergo QA review, limiting coaching opportunities and resulting in missed non-compliant calls.

Typically, based on industry benchmarks derived from a database of 15 billion touchpoints, typically only 1-2 sales calls per agent per week are audited for QA purposes. These audits are conducted randomly, targeting at least 30 high-risk touchpoints that QA needs to evaluate during a sales call. It is also worth noting that despite these efforts, there is typically at least one non-compliant call per agent each day. Furthermore, due to resource constraints, a QA professional can only audit a maximum of four enrollment calls per day.

When executed effectively, QA can be more than just a cost center – a revenue enabler. It can drive targeted coaching insights for agents, leading to increased sales conversion rates. When QA is done right, there is an added focus on quality of sales calls in addition to compliance checks. This approach allows for the capture of valuable and qualitative insights that would otherwise be missed due to the time spent on scoring numerous high-risk parameters. These insights help refine the sales playbook by adding data-backed inputs for different parts of sales calls such as objection handling, agenda statements, rapport building, and closing techniques.

This is where speech analytics (SA) can be beneficial. By utilizing speech analytics, call recording programs can transform into revenue-generating asset. SA can analyze 100% of the calls and identify previously unnoticed coaching opportunities.

Thinking of Investing in Speech Analytics for Growth?

Every health insurance agency has unique needs and goals that cannot always be met with a pre-packaged solution. That is why it is crucial to have a fully managed and customized solution that provides tailored support and services aligned with your specific business objectives. With a fully managed solution, you can rely on experts to manage maintenance, updates, and technical support, freeing you to focus on your core operations.

Provana’s advanced Speech Analytics platform, ICAP, has been instrumental in helping health insurance agencies identify the root causes of low sales and reduced revenue. One agency with over 1500 agents implemented ICAP and reduced their QA agent payroll cost by an astounding 80%. Moreover, they expanded coverage from small sample size to every single phone call, generating valuable insights that increased sales conversions by approximately 9%.

ICAP integrates all the essential features into one convenient platform. From your desktop or mobile device, you can access agent performance and QA data through intuitive yet data-rich visuals, providing a clear view of your entire collections funnel. This empowers you to understand which practices lead to better sales conversions.

Provana has built a dedicated team of speech analysts with extensive industry knowledge and expertise. This unique combination of technology and human insight is unmatched. To learn more about how our solution can benefit your business, click here.