PITTSBURGH, April 15, 2020 /PRNewswire/ -- Currently more than one third of the Medicare population enrolls in a Medicare Advantage (MA) plan, and the first point of contact between eligible individuals and health plans is typically with a call center. "However, the COVID-19 crisis is abruptly forcing MA plans to rapidly re-think and restructure their call center operations to meet new work from home (WFH) realities," states Patrick Phillips, CEO of Cavulus, a leading technology firm serving the MA industry.
Due to WFH and social distancing guidelines, traditional call centers can no longer operate with customer service representatives occupying the same physical space. Yet, there has never been a greater need for clear communication between insurers and beneficiaries. The rapidly growing MA program serves 23 million people, with an additional 10,000 individuals 'aging-into' Medicare eligibility daily and seeking coverage options guidance.
SOLVING THE DILEMMA
Assessing these factors, Cavulus has created MedicareVIP, Voice (over) Internet Protocol, the first-ever virtual contact center with fully integrated inbound and outbound calling features governed by CMS-mandated workflows and call scripts.
"We've been in close contact with our MA clients as this crisis has unfolded and there's an obvious, urgent need for virtual solutions that comply with the Federal regulations," says Phillips. "Call volumes have spiked, and insurers realize this will be vastly compounded during the Fall Annual Election Period."
Cavulus has exclusively served the MA industry since its inception in 2006. "We provide secure, compliant, Cloud-based solutions, so we're in a unique position to respond to this changing landscape," says Phillips. "Our newest capabilities enable insurers to immediately shift to virtual call center operations on a single platform - with their agents, third party call centers, independent brokers and enrollment personnel working from the safety of their own homes."
According to Cavulus EVP of Product Sean O'Sullivan, "Our MedicareVIP technology incorporates all of the features that call centers traditionally rely upon in an office setting, including agent monitoring, reporting, warm transfer and whisper features. These are integrated with our existing Cavulus MAP (Medicare Advantage Platform) products, which are widely used by insurers throughout the country, including the largest licensed Medicare Advantage agent networks".
"WORK FROM HOME" REALITIES
Even before the COVID-19 pandemic, the need for virtual tools across administrative and clinical functions has been growing. "Regionalized natural disasters like hurricanes and the recent California wildfires have disrupted business continuity more frequently. And other factors like recruitment of licensed talent and rising commercial rents have compelled MA insurers to consider remote operating models," explains O'Sullivan.
"However, this current crisis has dramatically expedited the shift to virtual contact," Phillips said. "Our Medicare population is among the most vulnerable to COVID-19, and understandably, there's a lot of uncertainty and fear. MA plans are under pressure to adapt and field agents are concerned about their livelihoods."
"Our MedicareVIP technology solves these issues," asserts Phillips. "It unifies communication and will keep an extraordinary number of knowledgeable insurance experts employed. MA plans can instantly engage their available telesales agents and broker networks by compliantly routing calls to them while they're working from home."
Phillips predicts: "It will need to be 'all hands on deck' during the Fall enrollment window. Most beneficiaries have access to 28 plans from seven to 10 insurers, and there are counties with as many as 60 different options. There are more choices than any prior year. The industry relies on qualified licensed sales experts, so we've easily enabled telecommuting to remove geographic recruitment and COVID distancing barriers. Our parents, grandparents, and neighbors can now be served by the best talent in the country."
NEW OPERATING ENVIRONMENT
"Recently, there's been an expanded use of telehealth allowing patients to receive guidance from their clinicians without traveling to a healthcare facility," notes Phillips. "Similarly, MedicareVIP remotely connects beneficiaries with a trusted Medicare advisor to navigate pharmacy and medical benefits."
"The new reality is driving an overwhelming call volume to limited resources within contact centers who've sent a majority of their customer service representatives home," acknowledges Phillips. "Moreover, field agents can't sit across a kitchen table to review benefits with beneficiaries. This complicates an essential service that must be seamless, all while adhering to PHI, HIPAA and CMS regulatory standards."
"These new circumstances have been the driving force for our latest solution," declares Phillips. "Our partners like UPMC and others are contributing on the clinical front during these difficult times. Everyone is helping how they can, and our Cavulus team is focused on empowering the MA industry so there's no lapse in critical communications, and no barriers to Medicare enrollment now, or in the future."
ABOUT CAVULUS - Cavulus is a technology driven specialist in Medicare Advantage insurance solutions. The Cavulus Cloud-based Medicare Advantage Platform (Cavulus MAP™) unifies marketing, sales and enrollment operations, and is utilized by many of America's top insurers, including several BlueCross/ BlueShield companies, UPMC Health Plan, Johns Hopkins Healthcare, Lumeris and United Healthcare. For details visit: www.cavulus.com.
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