When it incorporated speech-recognition technology into its call center operations four years ago, insurance giant Aetna Inc. had a few simple goals.
First, it wanted to streamline call center requests placed by healthcare providers and consumers. Second, the plan wanted to migrate away from its touch tone-driven phone system. Third, it wanted to offer telephone-based customer service around the clock. The health plan fields some 50 million calls annually related to health and dental insurance, so it figured by automating them, it could streamline its own operations as well. “We want to make interactions with us easier for members and providers,” says Dottie Verkade, head of speech innovation. “We wanted to personalize the calls.”
According to Verkade, the speech recognition technology has accomplished its goals. Now in its fifth year, “Aetna Voice Advantage” enables callers to use natural speech to solicit claims and coverage information. Aetna’s customers can perform self-service transactions without speaking to an operator. Now, when callers dial Aetna, they hear an automated voice that guides them through a series of questions designed to elicit the nature of the call. The voice is actually a combination of prerecorded statements and computer-generated synthetic language, Verkade explains.
When a medical provider calls, the system compares the provider’s phone number against a database, which offers a cue as to the caller’s identity, Verkade explains. Thus, a caller from Hartford Hospital would hear, “Thanks for calling. You’re calling from Hartford Hospital, correct?” After answering “yes,” the caller proceeds. The system recognizes about 95 percent of the language it hears, Verkade says.
Sometimes providers will answer a question by giving a service or diagnosis code. The system can recognize the code and tell the caller if a patient’s benefit plan would cover the proposed service, for example. About 20 percent of calls are handled entirely with the speech-recognition system, Verkade says.
Even when calls are only partially automated, Aetna’s operators still benefit, she adds, because the system will digitize whatever information the caller relays verbally, then present a summary on the phone operator’s screen if the call needs human intervention. —Gary Baldwin