Healthcare RCM

Tips for better QA in your healthcare patient contact center

A woman sits at a desk viewing a piece of paper. There is a laptop, a clipboard and other work materials.
Photo by Pavel Danilyuk

Healthcare contact centers aren’t the same as every other contact center. 

Consider this: A customer support center for a company might only handle incoming calls to support customer experience and issue resolution goals. Collections contact centers must address both incoming and outgoing calls to meet their repayment goals. 

But healthcare patient contact centers? 

They have to take care of all of those conversation types— plus conversations with the healthcare providers and insurance providers. They also have a greater variety of goals to achieve, as well as a highly regulated data environment, and arguably greater consequences when any errors occur in QA or patient experience. 

Add to it all that health is always a sensitive topic, and you can easily see why achieving optimal function in a healthcare contact center is a challenge. 

One way to rise to the challenge is to develop an efficient QA process that incorporates contextual meaning. Doing so should allow you to achieve both productivity and experience improvements with one single process improvement. 

QA in the patient contact center: Coverage and context

We all know that reviewing a small sample of calls each month isn’t cutting it when it comes to quality assurance. This practice leaves your contact center open to regulatory risk, and also ignores all of the important information you could glean from your many patient interactions. All that data is left on the table. Unfiltered, unreviewed. 

And yet, resource constraints make it nearly impossible to do more with it. How can you review every single call, and learn what you need to know, while becoming more efficient?

Find a conversation analytics solution with strong, accurate, out-of-the-box tags. This choice will allow you to automate review and receive clear alerts when a single patient call or an individual agent’s calls require a closer look. One hundred percent call coverage is the ideal. 

Of course, accurate review of every call depends on accurate context. 

If not, complete call coverage won’t satisfy the “better QA” goal. Better QA in the contact center requires two things. First, a way to understand the significance within a conversation. Second, a way to allow the significance within that conversation — and all conversations — to proliferate into future patient experiences. 

In other words, not only should you automate the QA review process, but you should also use your newfound insights from this process to create new workflows. Automated workflows can support your agents in compliant delivery

Agents aren’t compliance directors — and they don’t have to be. The best QA will not only be effective in process, but in future application. 

Furthermore, QA applies to so much more than compliance with regulatory requirements. You can improve every interaction to reach your standards following these QA updates. 

It may sound complicated, but when you boil it down, the tips for better QA are simple: 

  1. Automate Your Review Process
  2. Apply Your Context

Context comes from patient financial interactions

Everyone does QA differently. You might have QA people walking the floor, or you might pull in a randomly-selected call sample. You might have no QA team at all, and try to manage it as part of the general operations workload. You might only QA for regulatory reasons. Whatever resources you have, and however you choose to manage QA, one thing remains consistent: Patient and agent interaction is where the context lives. 

And that’s also where the long-term improvements come into play. How can you have the most efficient interaction with patients on any channel? How can your agents complete issue resolution in record time, while remaining compliant and in line with the provider’s experience expectations? How do you guarantee every patient has been treated properly and fairly? 

Today’s remote agent work environment necessitates a new way to ensure these questions are answered and their answers understood and implemented by agents. A great QA solution supports every patient contact center goal: Monitoring, insight, and action that improves every patient financial experience — efficiently. 

Ready to see what patients are really saying during your agent’s conversations? Ready to learn more about how you can predict big trends and use your QA resources effectively? Connect with the Prodigal team below.