Customer Service

Customer Service

Driving Exceptional Service

Advantasure’s call center solution integrates with other Advantasure modules to provide customer service representatives with the tools and information they need to address virtually any issue for any health plan constituent. With configurable user roles and workflow, the solution improves key operational measures and drives quality service that enhances relationships with members, providers and employer groups.

Efficient Workflow, Timely Responses

Robust technology is designed for addressing, tracking, and managing member, provider and employer group interactions in the call center environment quickly and efficiently. The solution enables you to reply rapidly to customers by automatically routing them according to user-defined categories and subcategories—all configurable for your business.

• Flexibility to assign access levels and roles to streamline workflow and automatically track the progress of follow-up tasks to drive timely service
• Comprehensive reports help measure performance and gain insight for improving customer service operations
• Automatically upgraded as updates become available
• Control user access at the screen or module level, then further designate full access, readonly access, or read/write access
• Configure different roles for different types of users and rules for each
• Manage new member workflows via a daily report that supplies a list for outreach calls and drives generation of new member kits and identification cards
• Generate reports by call category, line of business, type of call/caller, person handling, status, time to issue resolution, etc.
• Create reports that quantify volume, identify pended member calls, and help administer grievances and appeals

Easily configure the system without changing any code as market demands and business needs evolve.

• Configure user-defined call categories and subcategories as well as context-based documentation capabilities using auto-population of pre-scripted call documentation
• Configure automated work queues for routing inquiries to other departments or individuals within your health plan
• Maintain call records securely; once you add information to a record, it cannot be deleted or edited, only updated or supplemented
• Easily document all transactions in an inquiry and retrieve information with automatically assigned control or sequence numbers
• Attach all call inquiries to the member or provider record for easy access