Our Customer Service Philosophy
An Inside Look at Our Customer Service Centers
At Blue Cross and Blue Shield of Texas, we understand that our role is more than handling insurance claims. Our philosophy is to serve as a resource that provides members with all the information and support they need to get the most from their benefit plans and to be as healthy as possible. We work to offer a customized, personalized member experience.
Our number one goal is to build relationships with members so that we can become trusted advisors whenever they need assistance in understanding their health care options.
This member-centric philosophy is evident in how our service centers are organized and how we measure our success.
Customer Service Centers at Work
Our Customer Advocates:
- Are evaluated solely on customer satisfaction, not the number of calls they receive. And our customer satisfaction ratings are consistently above 96 percent.
- Focus on the member's needs, in addition to their questions, and consider it their job to answer the "unasked" questions that ultimately provide better assistance for the member.
- Have a solid track record of meeting members' needs the first time they call more than 90 percent of the time.
- Have the knowledge and experience to handle each call efficiently, accurately and simply for the member because of our stable environment due to high tenure and low turnover.
Our Commitment to the Customer
Service Philosophy in Action:
- Starts with being hands-on. Our customer service centers are located in communities across our four-state service area. We don't contract with a third-party call center service, and we don't have one massive call center at corporate headquarters.
- Includes investing in the technology, personnel and training to make the customer service experience simple, convenient and tailored to our members' personal needs.
- Shows that we understand our role is more than handling insurance claims. Our philosophy is to serve as a resource that provides members with all the information needed to get the most from their benefit plans and to be as healthy as possible.
Innovations
Our Member-Centered System:
- Enables the customer service center to handle all member-related activities – customer service, claims processing and adjudication, management of membership and eligibility information. In addition, the customer service center partners closely with medical care management regarding account issues and implementation.
- Automatically and quickly routes a member's call to the service center assigned to that member's benefit plan, and even to a customer advocate team member responsible for that account.
- Is organized to provide one-stop access for member inquiries. The customer advocate can explain benefits, answer claims questions and make adjustments on the spot, contact a provider to resolve issues while the member is on the line, and educate members on health and wellness benefits offered through their employer's plan.