Blue Cross/WellPoint Changes Detractor to Promoter

Another customer facing employee makes a difference!

In my last posting I told a story of my painful experience trying to get an allergy prescription refilled. The posting illustrated two primary issues, 1. the connectivity of our health care system from the insurance company, to the physician to the pharmacy, and 2. the customer experience at Blue Cross. At the end of my posting I was clearly a Detractor of Blue Cross and my husband wanted to switch insurance companies and suggested I write the attorney general. When I finished the posting I sent a link to the media contacts listed at the Blue Cross website and asked if they had anyone there that cared about customer experience. Today I found someone does care.

First thing this morning I get a call and an email from Sandy, a Director of Pharmacy services from Wellpoint. Here's an excerpt from the email:

Ms. Eastman - can you please call me to resolve your prescription issue with Blue Cross of California?

I understand you are having problems, and I would like to help.

I called Sandy right away and within 10 minutes she had resolved my problem and made sure I had a lifetime approval for the drug. WOW, she genuinely cared about getting my problem resolved! Then to WOW me even further she asked if I would take the time to explain my experience. I told her the story and she apologized for my experience, explained that they want to improve the connectivity between insurance, physicians and the pharmacy and to improve the overall patient experience. She also shared that I should not have been referred back to my doctor and that they would go back to the recorded call to learn more about what happened. That's the first time I had any insight into anyone actually using the recorded calls.

This story demonstrates the opportunity for organizations to address their experience issues and build customer loyalty. Friday afternoon I was clearly a Detractor for Blue Cross/WellPoint. As I do often when I have bad experience I tell everyone I know and I vote with my dollars. Thanks to the efforts of one individual at this company, I have moved to Promoter status. Why? Because, while Sandy was the hero in this story, someone from the media department routed this internally to get to the right people. This is an organization that is demonstrating they care enough to do something about their experience gaps. Sometimes a bad experience offers a greater opportunity to create Promoters than if everything is going well and you are "satisfied".

Thank you Sandy and Blue Cross/WellPoint for caring enough to do something about the situation and better understand the experience from outside your organizational walls. You have restored my faith in your organization and I'm hoping you can tackle the bigger issues of patient experience. I am impressed and will remain a loyal Blue Cross/WellPoint customer as long as you continue to demonstrate you care.

One last thing Sandy, after you tackle the experience issues, perhaps you can figure out the branding strategy for your company. Blue Cross/Blue Shield/WellPoint NextRX is pretty confusing. I see that you are a licensee of Blue Cross/Blue Shield for California and other states, but there should be a better way to represent the brand to the average consumer who won't Google you to understand who they are doing business with. But that's a topic for another day.

There is no "care" in Health Care

Perhaps my expectations are not set properly. Are we "customers" of the health care system or financial burdens?

Over a week ago I requested a refill for my allergy medicine. This is medication I have refilled several times, but this time I received an automated notice that my prescription cannot be refilled as it needs doctor authorization. How can it need doctor authorization when my doctor prescribed it to me?

So, I call my doctor and they tell me they have to authorize the insurance company. They ask me the same questions they ask every time, have I taken this or that. Yes, I have tried it all and this is one only medication that works for me. Why would I go through all this trouble if there is a solution I can pick up at the grocery store?

A week later my allergies are getting worse and my evenings are miserable. Today I call again, the pharmacy has no update, the doctor says they sent the authorization to the insurance company and they will send a message to my doctor. I decide to call the insurance company, that's when the real fun begins.

I call the contact center at Blue Cross, go through 5 menu options and get a recording that they are in a staff meeting and to call back. They do not offer me the option of leaving a message, the automated attendant actually said they are in a staff meeting, call back and then disconnected my call. WOW, that's the worst possible customer experience.

Thirty minutes later I call again and this time I skip the menu options and get right to a person. They, of course, can't help me. They transfer me to the "pharmacy" department where I give my member id, birth date, address and describe my problem AGAIN! This agent isn't very friendly, but I'm not very friendly at this point either. She asks me if they filled out a specific form. How am I supposed to know what forms they have to send back and forth? I'm a patient trying to get my allergy medicine, not an expert in claim processing. She tells me I need to call my doctor as they don't have the authorization. My doctor told me they sent the authorization a week ago, so it's clear that I am lost in this inefficient process.

I call my doctor's office again, only to have them tell me they will send my doctor another note. That's helpful!*#! Meanwhile, my eyes are puffy, I'm sneezing and enjoying all the allergens California has to offer. I'm lost in our health care system and I'll probably go down today and pay the $123 for the prescription and put us all out of this pain.

This experience demonstrates another challenge organizations face in managing their customer experience, partnership. How does your ecosystem affect your customer experience? While the health care system may not care if I'm a customer or not, organizations focused on growth need to understand how their partners affect the customer experience and eventually loyalty. If we weren't trapped in health care options based on the selection of our employers, I would be looking for a new insurance company today.