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How Contact Center Quality Monitoring Benefits the Healthcare Industry

How Contact Center Quality Monitoring Benefits the Healthcare Industry

The Contact Center is increasingly serving as the face of a company for customers. Contact center associates are often the only people within a company that most customers will ever get the chance to interact with. As such, they are often on the receiving end of customer frustrations, but they also have the opportunity to make the company look great – a daunting responsibility!

While Quality Monitoring solutions can help associates improve their performance, internal contact center monitoring efforts are often ineffective because contact center managers lack the time and resources to evaluate customer needs, associate performance, and opportunities to enhance customer experience. To jumpstart improvement, a proven approach is to bring in outside Quality Monitoring experts who can objectively assess associate performance and offer honest, practical insights and recommendations for improvement – particularly if an outsourcer is providing customer service agents. Companies that employ outsourcing partners need assistance monitoring the performance of both their internal contact center associates and the associates of their outsourcing partner.

Contact Center Quality Monitoring involves both the collection and mining of data from a company’s customer calls, email, chat, and social media – ideally combining it with other company data to derive insights from deeper in the organization. Quality Monitoring needs vary by industry, but one industry with very specific and complex Quality Monitoring needs is the healthcare industry.

Healthcare Quality Monitoring

There are a variety of reasons why monitoring calls for the highly regulated healthcare industry is a more complex process than monitoring calls in other industries. Health insurance providers handle calls from both members and providers and are required to meet specific compliance standards and contend with extensive regulations to maintain state contracts. They must monitor compliance in their contact centers and ensure that all vendors they do business with are complying with regulations and Service Level Agreements (SLAs), such as performing routine employee background checks.

Health plans that maintain a 4 or 5-star rating are more likely to receive and maintain government contracts so they must be vigilant about fulfilling SLAs for every government entity that provides star ratings. Third-party Quality Monitoring teams that are trained in the complexities of the specific regulations are best suited to help insurance providers monitor the performance of both internal and outsourced associates and achieve the highest Star rating.

A Success Story

For the last 3 years, Northridge has helped a non-profit healthcare insurance provider that uses a third-party outsourcing partner to augment the work of their internal contact center. The outsourcing partner is employed all year round but is primarily needed during the open enrollment period, from October through January. They typically take calls from customers who are shopping for private insurance or Medicare.

Northridge’s contact center experts monitor voice, chat, and web submissions for this client’s internal contact center. We also monitor the voice channel for their outsourcing partner’s contact center (the only channel used by this partner).

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Each associate is rated on multiple behaviors in addition to performance on compliance. Both internal and outsourced associates are evaluated against the KPIs that are important to our client. These KPIs include:

  • First Contact Resolution (FCR)
  • Customer/Patient Experience (CX)
  • Customer/Patient Satisfaction (CSAT)

Data analytics allow us to assess how the internal associates are performing benchmarked against the performance of the outsourcing partner’s associates. We review and action plan insights with our clients in quarterly business reviews (QBRs). This cycle of continuous monitoring and actioning has led to lasting improvements and supports a commitment to ongoing quality and measurable improvement.

Shortly after beginning this engagement, we advised our client that their outsourcing partner was not performing to expectations. Outsourced associates continuously scored low on behaviors and other KPIs that were important to our client and their scores were decreasing. In addition to sharing this finding, we conducted extra calibrations on the calls the outsourcing partner handled and identified issues of concern to address in training such as:

  • The vendor’s newly hired agents were missing basic knowledge of relevant customer service programs.
  • There were numerous instances of call avoidance identified.

Our client shared the findings and concerns with their outsourcing partner and requested that the outsourcing partner provide more training and/or retraining for their associates as well as a better measurement of KPIs and more feedback for the associates. As a result of these requests, the outsourcing partner’s performance has improved considerably.

After our client implemented our recommendations, their outsourcing partner achieved the following results in just one quarter:

  • First Contact Resolution: + 4 percentage pts.
  • Behaviors directly correlated with AHT:
    • Active listening and responding accordingly: + 6 percentage pts.
    • Being a brand ambassador: + 6 percentage pts.
    • Taking ownership: + 9.4 percentage pts.
  • Behaviors associated with compliance-related issues:
    • Documenting facts: +19 percentage pts.
    • Filing Complaints appropriately: + 19 percentage pts.

It was critical to discover the poor performance of the outsourcing partner and pinpoint the areas that were lacking so they could be rectified. Quality Monitoring made that possible.

Data Collection and Mining

Our Quality Monitoring solutions include both data collection and data mining. We show clients how to evaluate and use their data to improve associate performance. We identify performance issues and determine if they are improving or not and why. If clients don’t have access to or understand their data, we can help them collect it, mine it, and decipher the story it tells.

The Northridge Group’s Quality Monitoring solutions help clients collect and mine data from customer contacts across multiple channels. To learn how we can help you with your data collection and mining, contact us.

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