Empire Medicare Services (EMS) currently services five states in the northeast: New York, Massachusetts, Delaware, Connecticut and New Jersey. Their three call centers aid providers with information on patient eligibility, claim status, deductibles, procedure code pricing, payment status, phone numbers, addresses, Web sites and seminars.
With call volumes rising almost 30 percent every year, EMS needed a way to handle the increasing volume of calls from doctors’ offices and hospitals. They set out to find a solution to automate providing answers to common questions. EMS required a scalable solution that would also meet CMS (Centers for Medicare and Medicaid Services) guidelines for compliance with regulations including HIPAA.
EMS turned to MicroAutomation and their Vocalocity-powered VoiceXML solution to implement speech-enabled voice self-service application. The solution has not only improved EMS’ service levels, but also provides healthcare providers with automated access to needed information, and EMS with detailed reporting.
MicroAutomation’s EMS solution was designed for both portability and scalability. Use of open standards simplified integration with EMS’ various backend data sources and provides them with the ability to leverage these backend interfaces with no changes for unified Web-based customer support.
After just three months, EMS’ new 192-port speech-enabled interactive voice response (IVR) solution was handling more than 78 percent of its 15,000 incoming doctor and hospital calls per day. Today, the system processes more than 15,000 calls and 30,000 transactions daily.
As a result of the implementation, EMS achieved the best service level they have ever had on their busiest day of the year, “Black” Monday, the Monday after Thanksgiving.
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