Challenge

CAQH ProView® is the trusted industry standard for self-reported provider data. Acting as a “single source of the truth”, it allows providers to enter demographics, credentials and other information and share it with multiple health plans, hospitals and other healthcare organizations at once. This reduces the burden on providers, improves the accuracy and completeness of information that plans use for directories and other essential services.

To drive customer service improvement for stakeholders that interact with its systems, CAQH wanted to establish a customer success center equipped with the right skills to solve queries quickly, effectively and efficiently.

What Accenture did

CAQH and Accenture collaborated to reinvent the customer experience by harnessing talent, data and intelligence. CAQH and Accenture are empowering their customer agents to build new skills and deliver leading-edge helpdesk experiences.

Customer front and center

CAQH partnered with Accenture to enable the responsive front-line support ProView users need. Building on their longstanding relationship, including collaboration on ProView, the two organizations committed to deliver customer success capabilities grounded in intelligent operations.

CAQH and Accenture launched two customer success centers: providing Tier 1 support in Manila, Philippines, and Tier 2 support in San Antonio, Texas. The goal was to provide an exceptional experience that secured customers as avid CAQH supporters.

Our teams have expanded the services they provide and adopted new technologies to keep CAQH at the cutting edge. Today, customer satisfaction (CSAT) score and net-promoter score (NPS) for Helpdesk Operations are in the top 10% of the industry.

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Seamless customer interactions

Instead of being tied to scripts, agents provide consistent and seamless interactions via phone and web-chat. They are trained to pick up where their colleagues leave off, always rooting themselves in customers’ intent, preferences and history.

Examples of service enhancements include: Interactive Voice Response (IVR) authentication – a non-live contact interaction that enables CAQH to manage large call volumes and address customers’ needs efficiently.

Rapid Walkthrough Program – an end-to-end proactive coaching assistant for customers where agents help callers validate all necessary details to ensure a successful application.

"ProView Care" – a successful white glove initiative where dissatisfied customers are contacted by phone to ensure problems are resolved.

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Innovations have been introduced to maintain excellent service levels. These include bots to help merge duplicate requests, reducing the total number of requests reaching individual agents, along with Knowledge Navigator, a common platform and data store enabling integrated service operations and accelerated resolution.

Agents and technology

Technology tools play a key role. These include NICE (Notes Install Cleanup Executable) call recording, enabling managers to monitor call quality and address issues directly. NICE also facilitates advanced reporting and behavioral analytics.

As well as providing an alternate engagement channel, offering Live Chat increased NPS and agent productivity. Agents can now manage multiple chats simultaneously with excellent service levels.

Incorporating AI and machine learning will enable greater scalability, lower costs, improve service quality and enhance compliance. Additional planned investments include intelligent Interactive Voice Response (IVR) and screenshare capabilities.

CAQH and Accenture are continuously pushing the boundaries – both in the services customers receive and technologies that support their agents. Accenture SynOps a human-machine operating “engine” that optimizes applied intelligence, digital technologies and talent has been introduced. Harnessing data from Accenture client engagements and synthesizing this with CAQH’s data, SynOps helps identify opportunities to elevate customer success capabilities.

CAQH and Accenture are continuously pushing the boundaries – both in the services customers receive and technologies that support their agents.

People and culture

While standard metrics are still collected, customer success delivery is about much more than metrics. To continue to deliver exceptional experiences, customer success professionals must be part of a culture that helps them to thrive. To enable this, CAQH and Accenture empowered agents to think differently and act as gatekeepers to the human side of customer engagement.

CAQH and Accenture regularly plan programs and activities that foster engagement. Priorities include empowering agents to develop skills – including critical thinking, creativity and empathy – that build loyalty and trust. The emphasis is on giving agents the authority to do whatever it takes to provide proactive support and deliver superior customer service.

Each agent undergoes a rigorous three-week training before beginning customer-facing work, with a focus on data protection, industry knowledge, key processes and service rehearsals. Agents also receive continuous education customized to role and career path. This comprises several educational courses including but not limited to data privacy and improving customer service skills.

Value delivered

10%

Raised CSAT and NPS scores - these are now in the top 10% of the industry.

26%

Despite customer size increasing by 25% in 2019, monthly call volume has declined by 26% - thanks, in part, to self-service and omni-channel solutions, including live chat and AI chat.

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