Authenticx Improves the Member Experience During Medicare Open Enrollment

Conversational intelligence empowers health insurance companies to gain insights, improve member retention as October AEP quickly approaches 

Authenticx, the new standard in healthcare for listening to customer voices at scale, is providing AI-driven conversational intelligence solutions to the health insurance industry. With the Medicare Advantage (MA) annual open enrollment period (AEP) opening in October, health insurance organizations need additional strategies to grow membership and retain revenue.

“A smooth customer experience is paramount, especially during AEP,” said Amy Brown, founder and CEO of Authenticx. “Insurance company call centers field a higher influx of calls at this time because many members struggle to understand the nuances of Medicare plans or have questions about the annual notice of changes (ANOC). When they receive the ANOC, many customers feel frustrated with communication or isolated in navigating their benefits and may consider disenrolling from their existing plan if they can’t get help.”

The MA program empowers individual members to make and change plan selections by supporting an annual open enrollment period. It’s a high-risk/high-reward approach offering insurance organizations a significant opportunity to increase their membership if they’re well-prepared.

Authenticx technology enables these organizations to identify drivers of negative member perceptions about their MA plans by using AI to analyze the recorded Member Services conversations and surface signs of attrition. Additionally, the platform can create and analyze call montages using specific keywords to identify and resolve pain points, reduce membership churn and uncover opportunities for improving agent performance.

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Use Cases: Authenticx in Action

Authenticx leverages the Eddy Effect™, a proprietary machine learning model that identifies where customers become stuck in a frustrating loop of obstacles disrupting their ideal experience, as a key CX metric and driver of customer friction.

Health insurance companies can use Authenticx’s Eddy Effect metric and dashboard to pinpoint disruption by monitoring critical metrics, including call length, repeat callers, agent quality, estimated wasted spend for preventable calls, customer sentiment and more. The platform’s dashboard generates actionable, comprehensive reporting from a single set of insights.

Last year, leaders from one health maintenance organization (HMO) wanted insight into why more leads didn’t opt into its Medicare Advantage Plan. The insights from this study empowered the HMO to strengthen its agent-customer relationship by providing additional agent training to clearly explain brand value differentiators between the company’s Medicare Advantage Plan and those of its competitors.

After partnering with Authenticx, companies saw the following ROI:

• One client reduced member churn signals from 45% to 14% in four months
• Another MA plan increased its net new member growth by over 85%

Insights and Planning for the Future

Authenticx offers solutions specifically tailored for this enrollment period, empowering health insurance companies to listen not just for negative feedback and brand detractors but also for brand values to use in their marketing messaging — ensuring companies provide what’s needed to secure customer retention.

The functionality of Authenticx’s solution also enables companies to compare AEP data year-over-year, understand and compare seasonal trends, and anticipate what teams need to know before the next AEP opens.

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