Managed Care


25% of provider calls now automated

MANAGED CARE August 2004. © MediMedia USA
News and Commentary

25% of provider calls now automated

MANAGED CARE August 2004. ©MediMedia USA

Interactive voice response phone systems are being used increasingly by health plans in their dealings with with providers, but much less so for interactions with members, according to a study by Capgemini. The consulting company surveyed health plans that cover more than 16 million lives about how much they are investing in information technology.

The discrepancy between provider and member usage of IVR systems might be "driven by concerns related to payoff, the nature of member calls and member satisfaction," the study says.

It also states that "plans with lower claims costs tend to experience higher member inquiry volumes related to claims issues and appeals/denials of payment. Higher claims inquiry volumes relate to longer call handle times and fewer calls closed through interactive voice response."

Average percent of calls resolved through interactive voice response



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