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How Decision Management could improve my health plan’s customer service


Just a quick note today on the power of Decision Management in customer service.

I am on my health plan’s site, logged in and authenticated. I’m looking for some forms (because I have to fax a change in to them) but the site simply lists ALL the forms available. Why didn’t it DECIDE which forms were relevant to me (given I am logged in and a member of a plan)? Just dumping a long list of the PDFs is really pathetic.

Anyway, having scrolled through the long list of mostly irrelevant forms and documents it does not seem like they have the one I need (one referenced by the form I have already got). So I go to the contact us section to call them. Once again a long list of numbers. It has a whole set for people who are not members (even though the SAME PAGE shows that the site knows I am a member) and multiple numbers depending on which plan you are calling about (did I mention that the plan I am a member of is displayed right alongside this list because, remember, I am already logged in and identified).

And even then it doesn’t help because the name of the plan I have is NOT LISTED in the list of phone numbers. I am sure that one of the contact numbers is for a collection of plans that includes mine but there’s no name map at all.

Despite knowing who I am and that I am a member, despite being able to list all my claims and benefits, the rest of the information on the site is totally them-centered. If they were using decision management they would have recognized each of these as opportunities for a micro-decision, a decision just about me, and have shown me the forms that are relevant to my plan, my status and the contact numbers I need to use to contact them.

So how are you doing? Is your website (or portal) just spewing data over your users and hoping they will figure out what they need? Or are you using what you know to make decisions that will help them?

Happy Fourth of July everyone


Comments on this entry are closed.

  • Alex Johnson July 15, 2013, 8:15 am

    While I haven’t had that bad of an experience with any of my banks’ websites, I certainly have had plenty of sub-optimal experiences. It’s an interesting challenge for banks. As consumers stop using branches in favor of digital channels, it is going to become increasingly important for banks to offer personalized customer service through self-service channels that is at least as good as the branch, if not better.

  • Shelley Ehrman August 2, 2013, 9:53 am

    I had a similar experience with my health plan. I was on their affiliated Pharmacy by mail site and it told me I needed to go to my payor’s site to update my payment information. It did not provide a link. I went to my payor’s site and searched for a way to enter payment information — to no avail. So I had to call them. They couldn’t find it on the site either, so I ended up providing it over the phone. Ridiculously poor experience.