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Blue Cross speeds up its customer service for one week

Nobody looks forward to calling their health insurance company with a question, complaint, or claims adjustment request. But if you had to contact Blue Cross Blue Shield of Massachusetts this week, the experience might have been more pleasant than usual.

Because Blue Cross knew people who called its member services lines from Oct. 15 to 19 would be surveyed by an outside company to gauge their level of satisfaction, the Boston-based insurer prepared a special script for customer service representatives to follow this week only.

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Tasks that normally can take 10 to 30 days to complete — such as correcting mistakes on an insurance bill, or sending members a chart detailing their deductions under flexible spending plans — this week would be addressed the same day the requests were made.

The script given to customer service representatives read in part, “I will work on this today for you as a priority. I will also have a team member call you back later today to let you know the action we have taken to finalize this claim for you,” according to a copy obtained by the Globe.

To stress the importance of treating customers well this week, daily survey results were posted on white boards and managers rolled out carts with free snacks, coffee, and other beverages.

The data will be used internally to compare Blue Cross Blue Shield of Massachusetts with other Blue Cross health plans across the country and to measure the insurer’s progress in improving customer service, said company spokeswoman Sharon Torgerson. Each insurer is independently operated, but part of the national Blue Cross and Blue Shield Association, which sets some financial guidelines for the plans. The survey results are not made public.

Torgerson described this week’s special protocol as a “pilot program” to speed up service. If successful, she said, it could be implemented on an ongoing basis later this year or in 2013. She acknowledged the enhanced customer service push — which did not require additional staffing — was related to the “survey quality measurement” being conducted by a vendor.

‘It appears to be gaming the survey. In the end, that’s a disservice to the consumer.’

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“We’re focused on customer service every day, not just this week,” Torgerson said. “Our mantra is: Always put our members first. We’re always measuring our customer service department on a variety of measurements, such as first-call resolution and member satisfaction. We are an industry leader in service.”

But consumer advocate Deirdre Cummings, legislative director for the Massachusetts Public Interest Research Group, said the special work flow procedures show Blue Cross — the state’s largest health insurer — has the ability to handle members’ requests and complaints faster than it normally does.

“It appears to be gaming the survey,” Cummings said. “In the end, that’s a disservice to the consumer. The results are artificially inflated. The question it raises is: why not do this every week? Clearly, they have the capacity to resolve complaints quickly. They’re demonstrating that capacity.”

The instructions issued to customer service employees were explicit.

“Please use these workflows to ensure Member Satisfaction during SQM week,” the instructions advised, referring to SQM Group Inc., the Canadian survey firm that Blue Cross and more than 400 other companies use to measure themselves against peers in various industries. “Thank you for all your hard work and dedication to our members!!”

One service representative, who spoke on the condition of anonymity because he did not want to hurt his career or affect his colleagues, said call center employees have been asking one another why enhanced customer service should be limited to one week when large numbers of the insurer’s 3 million members call for help throughout the year.

He said service representatives have been told on other weeks to advise callers it will take 10 to 14 days to complete most requests, but some could take as long as 30 days. Members, he said, are typically not called back to be updated on the status of their claims or requests.

Customer service has become a more pressing issue for health insurers in recent years as employers have balked at rising premiums and members have grumbled about new plan designs with higher copays and deductibles as well as products that limit which doctors and hospitals they can go to or require them to pay more to see out-of-network physicians.

Blue Cross Blue Shield of Massachusetts was named the nation’s 14th top health plan in member satisfaction and quality of care, according to a ranking last month by the National Committee for Quality Assurance.

But several smaller competitors scored higher, including Harvard Pilgrim Health Care of Wellesley, which topped the ranking, Tufts Health Plan of Watertown, which placed second, and Springfield’s Health New England, which ranked 11th.

Torgerson said Blue Cross has taken a number of steps to boost customer service, and designated the week of Oct. 12 as “customer service week” to encourage better relations with members and employers.

Blue Cross has also been running customer service advertisements on television and the Internet along with other advertisements celebrating the insurer’s 75th anniversary and promoting its new supplemental Medicare products.

Robert Weisman can be reached at weisman@globe.com.
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