Health Plan ChatAnswer-coverage review · prepared for
. plans.
One deck, rebuilt per agency · every bracket is filled from that agency’s own plan documents before the call
A week holds one hundred and sixty-eight hours. Somebody at your agency can answer a question about one of your plans in of them.
Answerable hours per week
One hundred and sixty-eight hours. A question about one of your plans can be answered in of them.
Worked out from the opening hours published on your own website. You can check it while we are talking.
The object on this slide is the week as one solid block, with a band lit across the foot of it. The lit band is twenty-five hours out of one hundred and sixty-eight, drawn to scale.
Each block below is one hour.
Open vs reachable vs answerable
Open, reachable, and answerable are three different numbers.
- Open for business. hours out of one hundred and sixty-eight.
- A caller could reach a person. hours.
- A person could answer a question about a plan. hours.
Reaching somebody and getting an answer are two different events. A message taken at seven on a Friday evening is the first one, not the second.
What the published opening hours say. It is the number your own website already promises.
Somebody picks up. The message is taken accurately and the caller is told when to expect a call back.
Somebody who can open the Summary of Benefits and answer the question is sitting at the desk.
Press one, two or three.
Reached, but not answered. hours a week where somebody picks up and the plan question still waits until morning.
A question your callers actually ask
“”
You told us this is one of the three your callers ask most often.
Where after-hours questions go
Four things happen to that question. None of them is an answer.
- It becomes a recorded message.
- It becomes a note for somebody who has to look it up.
- It becomes a call back the next morning.
- It becomes a question they never ask again.
Every one of those is somebody at your agency doing their job correctly.
Press one, two, three or four.
The answer is in your plan documents
Nothing here is missing. It is printed in a document you already own.
It is in the Summary of Benefits for the plan that caller is on. About three minutes of work for somebody who knows which page to open.
The object on this slide is a printed page, with one line marked as the line that holds the answer.
Three minutes is nothing at eleven in the morning. It is everything at seven in the evening, and the caller has no way of knowing which one they have reached.
The answer is on this line. About three minutes of work.
What a supplier must have built
What a supplier has to have done before it can answer that question.
- Layer one. General purpose voice technology. Answers the telephone, sounds human, takes a message and writes it down. Many suppliers.
- Layer two. Insurance work. Knows what a Medicare call is: qualifying, the required disclosures, and handing over to a licensed person. A few suppliers.
- Layer three. Knowledge of your own plans. Has read the Summary of Benefits for the plans this agency sells, in these counties, for this plan year. One agency at a time.
The first layer is something a supplier switches on. The third is reading work done for a single agency, which is why nobody can ship it to everyone at once.
Reached by buying it. Many suppliers are already standing here.
Reached by learning one industry once, and then selling that same learning to everybody in it.
Reached by reading one agency’s plan documents, for these counties and this plan year, and then doing it again for the next agency.
Press one, two or three.
Each layer is narrower than the one below it.
Scope: what it answers, what it refuses
“So what stops it making something up?”
When it hands over, your agent gets the whole conversation, not a message. Nobody starts again from the beginning.
Press one or two.
What it answers
What a plan covers. Dental, vision, hearing, transport, and the over-the-counter and flexible spending allowances.
Premiums, copayments and cost sharing, for a named plan.
In your agency’s name, evenings and weekends.
With its source attached. Every answer traces back to the carrier document it came from.
What it refuses
Booking an appointment. Not built. It takes the caller’s details and hands them to you.
Recording a Scope of Appointment. Not built. That is the form recording what a caller agreed to discuss.
Recommending a plan, or enrolling anyone. That is licensed advice. It hands over, and it always will.
Saying whether a doctor is in the network. Hands over to you.
Accuracy rule: no guessing
When it does not know, it says it does not know.
It is built to prefer that over an answer that merely sounds right.
Test that first, not last. Ask it about a plan you have not sent us and watch what it does. If it invents an answer, do not buy it, and you will have found that out on a private number rather than from one of your members.
Compliance built into every call
Four things happen on every single call.
We are not certified under any security standard, and there is no such thing as a certification for handling health information. If your review needs our arrangements in writing, ask and you get the pack.
Press one, two, three or four to turn one over.
Your four options, compared
Four options, and one of them is carrying on exactly as you are.
- Carry on as you are. A recorded message and a call back the next morning. It costs nothing, and nobody counts the callers who do not come back.
- Hire somebody. More hands inside the hours you already open. Takes a season to learn your plans, and never reaches a Sunday evening.
- A general answering service. Answers immediately, writes the message down accurately, and has never read your plans. The question still arrives on your desk.
- A line that has read your plans. Answers from the documents for the plans you sell, in your name, and hands over anything that needs a licensed opinion.
There is one product with Medicare knowledge comparable to ours. It is built for operations several times your size, and it is sold through a demonstration and a written quotation.
Press one, two, three or four.
* after a season of learning them, and only inside the hours you open.
Two things we have not built
Two things are not built, and either one may matter to you.
The first. Booking an appointment. It takes the caller’s details and hands them to you. It is on the plan without a date, and if booking inside the call is essential to how you work, that is a reason to wait.
The second. Recording a Scope of Appointment. That is the form recording what a caller agreed to discuss before an agent may discuss it. If your process needs it captured in the first call, that is a real gap today.
Both are drawn here as empty outlines, because that is what they are.
Dates to be live before enrollment
Two dates, and then it is a January conversation.
- . Documents by here and you get the fortnight on a private line first.
- . Documents by here and you are answering on the day the window opens.
- The fifteenth of October. The Annual Enrollment Period opens.
The Annual Enrollment Period is the yearly window when people on Medicare can change plan. It opens on the fifteenth of October and closes on the seventh of December. There is no limit on places and no discount that expires.
What we are offering: 168 hours covered
One hundred and sixty-eight hours. All of them covered.
Send us the plan documents you already have. Five working days later you get a private number, and a fortnight to try to break it on your own hardest questions. You are not signing anything to do that.
Our pricing reaches you in writing today either way, whether or not you send anything.
The object on this slide is the same block as the week, now lit from end to end. All one hundred and sixty-eight hours are covered.
Every one of them answerable.