Who's Answering the Phone?

Humana Military Healthcare Services, based in Louisville, Kentucky, provides health insurance to every branch of the American military. Not surprisingly, Humana gets a lot of telephone calls—some from vendors, but many more from military personnel and their families, who wonder how to find a doctor and whether a particular procedure is covered.

The volume of calls left Humana, a client of Plymouth-based Spanlink Communications, Inc., looking for a way to efficiently answer its telephones while maintaining excellent customer service. Having an agent answer every call would have been much too expensive, says John Jones, a senior systems manager for Humana. “You can’t staff a call center with an unlimited number of people,” he says.

At the same time, Humana didn’t want all its calls answered by the least expensive option—namely, an automated system. Some of the questions that clients ask concern personal information, and “if it’s private information, it’s best handled by a person,” Jones says. And the company felt that good customer service meant offering at least the option of talking with an agent.

So Humana compromised. The company now uses an automated system to answer the company’s most frequently asked questions, including the status of a referral, a provider’s location, benefits, and eligibility. Callers with other concerns, or who prefer to speak with an agent, can easily reach one by listening to the automated system’s options.

The system has allowed Humana to save on its employment costs. In an average month, Jones says, the automated referral inquiry system takes the place of 10 full-time employees. The system’s ability to answer questions about eligibility takes the place of an additional 14 full-time workers.

Not every company has Humana’s concerns, but virtually every company has to decide how it will respond to callers. The most expensive option—employees who answer each telephone call—is right for some firms. Others may be able to use the least expensive option—an automated system that answers every call, with little or no option of letting the caller speak with a person.

For most companies, however, the answer is somewhere in the middle, with automated systems that answer common questions, gather information, and route calls to the appropriate employees.