Blogs

There is an increasing interest in the quantified self movement and personal analytics.  Some of the stuff that Stephen Wolfram is doing is unbelievably cool, and only slightly weird.

The debate about telecommuting is not winding down. Perhaps because the debate has been framed as a yes/no decision for companies. “Should Companies Ban Telecommuting?” “Was Marissa Mayer Right?” The discussions generate far more heat than light.

It’s too bad. Clearly telecommuting is here to stay for all kinds of workers. Eventually many jobs (call centers, insurance claims processing and some back office functions) will be staffed almost entirely by remote workers.  

Marissa Mayer of Yahoo shocked the world when she mandated that Yahoo would no longer allow employees to work remotely full-time. As one part of her plan to turn the company around, Mayer wanted to make sure it’s all hands on deck at the Yahoo offices. Some Yahoo employees, both current and former, have said Mayer made the right move.

Major changes in the healthcare landscape including ICD-10 implementation, medical loss ratio (MLR) mandates and CMS star scores are having a dramatic impact on healthcare payers and stakeholders. These changes impact how insurance claims are processed and paid.  Both auto-adjudication and manual claims payment processes have grown into complex systems over the years.  With these changes, it should be expected that there will hiccups and bumps in the road as the industry changes.

Although a reported 79% of healthcare claims are processed by an auto adjudication system, significant investments (including both technology and people) are still needed in healthcare payer organizations to handle the manual processing of claims. However, manual claims processing operations face a lack of into work done at the individual processor level, which is where the real changes for improvement will happen.

The Wall Street Journal had an interesting article talking about how younger workers are more comfortable sharing their salary information with their co-workers.  According to the article, “Comparing salaries among colleagues has long been a taboo of workplace chatter, but that is changing as Millennials . . . join the labor force.”

According to the American Medical Association almost one in five (19.3%) of medical claims processed by the largest commercial health insurers is inaccurate. Imagine being one of those patients that goes in to see your doctor for a sprained wrist and a few weeks later receives a bill for a “short leg splint calf to foot.” Last time we looked your wrist is nowhere near your foot…While it might sound ridiculous to think that such a grievous mistake could happen clearly it happens far more frequently than many patients realize.

It’s safe to argue that FCR (First Contact Resolution/First Call Resolution) is the single most important metric in a call center. Not only does an improved FCR rate help reduce costs (fewer callbacks means less overhead), when a call center focuses on improving FCR their customer satisfaction score also tends to improve alongside it.