Smart Systems Anticipate Customer Needs and Provide High-Quality Service at Blue Cross & Blue Shield of Rhode Island

Overview

How one company retains customers, grows revenue and improves the responsiveness of its customer service

Challenge
Blue Cross & Blue Shield of Rhode Island – the state’s largest locally based non-profit health plan – realized that it needed to proactively retain and grow its customer base in order to differentiate itself from the competition. At the same time, it sought to enhance the responsiveness and accuracy of its customer communications while increasing the overall productivity of its service center. Technical challenges included the multiplicity of data sources to contend with, coupled with the tremendous volume of inquiries to which service representatives (CSRs) had to respond each day.

Solution
BCBSRI ultimately selected the PegaHEALTH Member Services solution: a system that automates functions and drives accountability – and, in so doing, permits CSRs to focus on servicing customers rather than processing paperwork.

Results
PegaHEALTH Member Services was the right choice for BCBSRI; the solution provided the functionality the health plan needed right out of the box, and its ease of use and simplified integration allowed the organization to rapidly overcome technical hurdles and produce positive ROI in record time.

Learn more about how Pegasystems SmartBPM solutions anticipate customer needs and provide high-quality service:

Read this Blue Cross & Blue Shield of Rhode Island case study...