Case Study: a large health care insurance plan achieves 86% FCR and 90% customer satisfaction with SQM Group

a large health care insurance plan improves first call resolution to 86% with SQM Group

The customer, a large health care insurance plan, sought to improve its customer service performance and member experience. They partnered with the vendor SQM Group, utilizing their mySQM™ Contact Center FCR software and customer journey mapping expertise to identify key pain points and opportunities for improvement, particularly around non-First Call Resolution interactions.

SQM Group implemented a holistic customer journey mapping solution that incorporated voice of the customer research and speech analytics. This process enabled the healthcare plan to make targeted people, process, and technology improvements. As a result, they achieved an 86% First Call Resolution rate and a 90% Customer Satisfaction score, earning SQM's world-class certification. A specific initiative for member-submitted claims led to a 4% increase in FCR for that call type and a 30% reduction in claims returned due to missing information.