For payers

Member experience


Speed-to-value outcomes from stellar NPS® to savings

A next-generation member experience has never been more essential

According to Forrester Research, consumers are 64% more likely to stay with a healthcare plan if satisfied—with 84% of members advocating for their brand.

To meet the escalating expectation for optimized health plan experience, the successful equation is not just speed + value, but speed-to-value, to engage and satisfy members and drive down costs. For brand ambassadors on the front line of today’s optimized member experience, responsiveness, speed, and personalized omnichannel delivery are crucial to the success that we achieve for our health plan clients.

64%consumers are more likely to stay with a healthcare plan if satisfied
84%of those members advocating for their brand

Member experience excellence: HGS Healthcare solution features

Our transformative member experience support will engage and retain your members for optimized support that also helps them lead healthier lives.

For our national payer clients, our solutions drive real outcomes for custom member experience solutions across vast lines of business, including Medicare, commercial, specialty, and international.

We customize our solutions to align to a customer journey and experience that sets brands apart with best-health service excellence. From omnichannel onboarding of members to decreasing the timeframe to enroll a new member, we ensure a superior and efficient member experience. We consistently provide breakthrough value and deliver improvements leveraging digital innovation, such as our intelligent interaction analytics platform and our performance automation tool (PAT).

Concierge care building best health outcomes

image of a team in training session

Right talent profiling and training

Our stringent profiling and hiring ensures your required competencies are mapped to relevant assessment filters. Once we have hired our top-notch ambassadors, we provide them with 35+ dedicated hours of education on healthcare economics, expenditure, and the enrollment process. Then, we support our talent with 1-week foundation training, 3 weeks of process training, and 1-week nesting with 6 graded mock calls.

Strategy for stellar NPS® and CSAT

With our customer-centric people, process, and technology, we earn high-bar NPS® and CSAT ratings from your members. Our quality management comprises an audit plan with service recovery triggers, side-by-side, and live remote monitoring. We work from a balanced scorecard to ensure we meet and exceed critical metrics.

NPS score

Digital transformation for savings and CX

As an innovation hub with in-house automation and analytics experts, we deliver member experience excellence with AI and automation, interaction analytics, digital deflection, and process re-engineering.

Our purpose-built Intelligent interaction analytics platform (IIAP) comprises customized tools via a unified dashboard, combining voice, text, and structured data, an automatic speech recognition toolkit developed in-house, and natural language processing (NLP) rules designed to analyze text and CSAT response.

Our concierge self-service engagement includes a conversational AI-bot to answer and resolve top member inquiries – expanding digital self-service with web-based chat bot, and VIVR via invisible app increasing calls resolved via self-service options. All of our digital expertise is driven by customer journey mapping, with value-stream alignment to top call drivers and sourcing of opportunities to improve up-stream and downstream processes to reduce customer effort and improve brand value.

Cost-effective scalability and rightshoring of resources

We provide appropriate and cost-effective geographic service delivery aligned to client needs. Our business continuity program is grounded by flexible bricks-and-mortar (B&M) and work-at-home delivery models for resilience and flexibility. We can scale with an industry hub for BPO services and strong resource pool availability.

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Axispoint accreditation case management

Our healthcare accreditations

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