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Sutherland Healthcare Group Created with Sketch.

Contact Centers

Member Support Services

Acquisition

Sutherland is a leading provider of member acquisition services to health plans. We use insights based on member demographics and profiles to improve acquisition and targeting tactics. This helps health plans better understand prospects’ needs and anticipate decision triggers around plan selection.

Enrollment

Handling the influx of calls during open enrollment period is incredibly costly and time consuming for health plans. Whether it’s handling members questions related to their benefits, eligibility, or networks, many health plans do not have the scalable resources to handle this influx.

Sutherland helps health plans handle open enrollment periods. Whether it’s a member inquiry, new member welcome call, or appointment reminder, our services ease the burden of enrolling new members. Our enrollment services help health plans enroll the right members in the right program at the right time.

Outbound Education and Verification

Health plans must continue to empower and communicate with their members about their health benefits and options. As healthcare shifts to a value-based model, it’s imperative to empower members to make healthy lifestyle choices and find the best long-term care options for their unique situation.

Sutherland is a leading provider of outbound education and verification services to the health plan industry. We help health plans empower their members with the right information, through each member’s preferred communication channel. This encourages members to make the best long-term care decisions and helps keep health plans profitable in this new era of value-based care.

Member Engagement

Individual member engagement is new territory for most health plans. With the influx of new members, especially those who haven’t had health insurance for years, it is more important than ever to provide a compelling experience for members.

Sutherland is a leading provider of member engagement services to health plans. Our engagement services help health plans drive behavior change, reduce risk in their pools, and improve health outcomes in this new era of value-based care.

Consumerism

Today's members are being asked to take on more responsibility in finding a health plan that meets their needs, preferences, and budget. This type of research often requires the type of member engagement that many health plans don’t have the capabilities to properly manage.

Sutherland helps health plans properly engage and create better experiences for their members. Our consumerism offering focuses on four key pillars: identification, acquisition, engagement, and retention. With Sutherland, health plans are able to improve their profits by selling more profitable offerings and avoid churn of their most profitable members.

Digital Services

It’s no longer simply about calls, health plan members expect to engage in quicker, more convenient ways than ever before. Whether it’s through social media, emails, web forms, chatbots, or some other digital channel, if a health plan doesn’t meet their member’s needs every time then that member will find a new health plan who does.

At Sutherland, we understand the importance of every single interaction and creating a true omni-channel experience. We work to not only improve each interaction but to better design, automate, and anticipate members’ needs to significantly reduce contact center touchpoints.

Inbound and Outbound Calls

Healthcare is complex and members are bound to have questions. Whether it’s understanding their care options or asking about a claim’s status, it’s important to give them an empathetic human voice to help them handle any questions or concerns they might have.

Sutherland is a leader in providing inbound and outbound contact center services to health plan members. With 24x7x365 global capabilities, we help health plans improve the experiences and outcomes they provide to their members.

Health Provider Support Services

Inbound and Outbound Calls

A contact center isn’t just for members. Hospitals and physician practices also need quick and convenient access to the member’s benefits or claims information. This not only helps the health providers handle their internal processes but helps improve the member experience for health plan’s members.

At Sutherland, we understand the importance of providing a top-notch inbound and outbound contact centers to health providers. Whether it’s a simple claims inquiry or understanding a member’s insurance status, keeping health providers happy has a direct impact on the member’s overall experience.

Claims Inquiries

An often-underestimated way to improve the member experience is by providing quick and accurate claims information to health providers. By providing this information, health providers are more easily able to manage their billing and collections task, helping improve the overall experience for a member.

Sutherland has experience in handling these types of health provider claims inquiry calls on behalf of our health plan clients. We know that by providing quick and accurate claims information to health providers, a member’s claims can be processed correctly the first time and their overall healthcare experience is drastically improved.

The impact (value, savings)
  • Licensed agents in all 50 states
  • Global delivery model to provide 24/7 support
  • Improve the overall member experience
  • Increase retention rates of the most profitable members
  • Lower administrative costs to better meet medical loss ratio and other regulatory requirements
Our experience
  • 10M annual contact center calls
  • Six of the top 10 health plans are Sutherland clients
Who we help
  • Large, national health plans
  • Regional and BCBS health plans
  • Health software vendors
  • Government health insurance programs
Our differentiators

A renown leader in contact center services

Sutherland has been ranked a leader by Gartner, Horses for Sources, Everest, NelsonHall, and many others for our ability to provide contact center services. Customer lifecycle management has been in our DNA since day 1 and we continue to find innovative ways to delight our clients and their customers.

Our consumerism-driven, analytics-based technology stack

Sutherland leverages a blend of proprietary and industry-leading technologies to create an offering that helps health plans take advantage of healthcare’s new consumerism era. Our technology stack allows us to better find, attract, and engage members in ways health plans have never done before.

Opening/Introductory

Consumerism has hit other industries hard and is making inroads into the healthcare industry. As members are increasingly asked to make difficult decisions for their healthcare options, trying to make the best decisions for quality and cost just as they do with any other service. These members are spending more time trying to find the right information and connect with the best resources out there to ensure they make the right choice.

Every time a member calls a contact center, it should be viewed as a failure. This means somewhere along the way the member wasn’t given the information they needed — when, how, and where they wanted it.

From increasing member retention to improving overall satisfaction, Sutherland’s focus has always been the total customer experience. That’s why we dive into what initially drives that call center contact — the journey maps, member experiences, and the originating trigger events. From this analysis, and through better design, automation, and anticipation of members’ needs, we can prevent the frustrating ambiguity and subsequent problems that arise and significantly reduce contact center calls.

Our thinking (White papers, blogs)
Our work (Case studies)