Client Overview

A leading telemedicine and healthcare provider faced significant challenges in managing patient support operations. As demand for virtual healthcare services surged, the company struggled with long wait times, high call abandonment rates, and compliance risks. The client sought a strategic outsourcing partner to streamline operations while ensuring regulatory adherence and enhancing patient satisfaction.

Challenges

  • High Call Abandonment Rate (40%), resulting in missed patient consultations.
  • Long Average Handling Time (AHT) of 8 minutes, causing frustration among patients.
  • Inefficiencies in Appointment Scheduling, leading to a 20% drop in patient retention.
  • Compliance and Data Security Risks with HIPAA and other healthcare regulations.
  • Lack of an AI-Driven Triage System, causing delays in routing patients to the right departments.
 

Solution: Implementing the Lean Six Sigma Framework

To address these critical challenges, NEXperience applied the Lean Six Sigma methodology to optimize healthcare customer support operations, improve efficiency, and enhance patient experience.

DEFINE

We collaborated with the client to establish clear objectives:
  • Reduce the call abandonment rate to below 15%.
  • Lower AHT to under 5 minutes.
  • Increase appointment scheduling efficiency by 40%.
  • Ensure 100% HIPAA compliance through process automation.

MEASURE

  • Collected historical patient support data, analyzing patterns of abandoned calls, escalations, and agent performance.
  • Conducted a workflow assessment to evaluate inefficiencies in call routing, triage, and verification processes.
  • Measured the impact of compliance gaps on operational risk and patient trust.

ANALYZE

  • Identified that 25% of calls were non-urgent and could be handled by an automated system.
  • Discovered that agent inefficiencies stemmed from a lack of a unified knowledge base.
  • Found that manual appointment scheduling contributed to 30% of delays in response times.
  • Recognized a high-risk area in data handling, posing a threat to compliance.

IMPROVE

  • Deployed AI-Powered Virtual Assistants to handle non-urgent inquiries, reducing agent workload by 35%.
  • Implemented a Smart Scheduling System, integrating automated booking and patient reminders, reducing appointment scheduling errors by 50%.
  • Developed a Unified Healthcare Knowledge Hub, improving agent response accuracy and reducing AHT to 4.5 minutes.
  • Enhanced HIPAA Compliance Monitoring, integrating real-time alerts to ensure full regulatory adherence.
  • Optimized Call Routing with AI-based Triage, directing patients to the right department 20% faster.

CONTROL

  • Set up real-time performance monitoring dashboards to track call efficiency and patient satisfaction.
  • Conducted weekly compliance audits to ensure data security and HIPAA compliance.
  • Implemented a continuous feedback loop, allowing agents to report bottlenecks and suggest improvements.
 

Results Achieved

Why NEXperience?

  • Industry-Specific Expertise: Specialized in healthcare outsourcing, ensuring deep compliance knowledge and CX optimization.
  • AI-Driven Solutions: Seamlessly integrating automation with human expertise for scalable patient support.
  • Lean Six Sigma Excellence: Proven methodologies to enhance efficiency, reduce costs, and improve overall patient satisfaction.
  • End-to-End Healthcare Support: From appointment scheduling to claims processing, ensuring a seamless experience.

Conclusion

By implementing Lean Six Sigma principles, NEXperience successfully transformed the client’s healthcare support operations, ensuring compliance, efficiency, and superior patient experience. Our innovative approach allowed the client to scale operations while maintaining a high level of service and regulatory adherence.
Looking to enhance your healthcare customer support operations? Contact NEXperience today to explore scalable solutions for your business.