Common sense and member service
I purchase my family’s health and dental insurance through Carefirst BlueCross BlueShield. As I am sure most of us have experienced very few doctors and dentists file claim’s on the patient’s behalf and then bill you for whatever you owe after the get compensated by the insurance company. I recently sent in a claim for a dentist visit by my wife. I filled out all the proper forms, attached the bill from the dentist and mailed it in as instructed. The forms came back about a week later with another form attached that stated that had a checklist of what I assume are common errors. It was a list of about 10 things that could have possibly been wrong with the forms that were submitted and the box was checked next to “date of service not included.” I know my dentist always includes the date of service so I immediately went to the form and say that in one place the date was illegible but down at the bottom of the form it stated the date in clear handwriting. Apparently the member service representative who got that form was told that if they run into issues where something is wrong they are to follow the procedure book and fill out the appropriate form, stick it in an envelope and mail it back to the customer. Is it only me or does this seem kind of crazy? The member service rep could have simply looked more closely at the form and if there was still a doubt as to when the date of service was they could have picked up the phone and called me or the dentist to confirm. The call would have taken 2 minutes which is probably as much time as it took this person to get the form, fill it out, stick it in an envelope and mail it. It also would have saved the company the cost of postage as well as helped save some trees because they would not have had to use additional envelopes or forms to send the stuff back to me. Finally, they would have avoided aggravating a paying “member” (yes, they call me a member and I have a member card and contact member services when I have issues) since I now have to correct the tiny mistake, find a new stamp and envelope and mail it again.
I bring this up because I really hope that member service at associations is not like this. I understand the need to have processes and procedures and feel they are very important. I also know that using some common sense, taking a little bit of initiative and doing things slightly differently to make your members happy is always something we need to take into consideration.
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Comments
Earlier this year, Ohio's Governor issued an Executive Order requiring all state employees to "use common sense" when dealing with Ohio businesses. I am not certain the approach to be taken if not a business......but this was in a sense a "values proposition" that the Governor was mandating all adopt and internalize. On the one hand, sad that such executive action was required, but then again, we are all chided to construct vision, mission, and "values" statements as companion to our strategic plans (if you still author one - see recent blog). In 1776, Thomas Paine published his famous pamphlet, "Common Sense," laying out his argument for the "obvious" perspective of seeking independence. Perennially, Congress wrestles with the passage of a "Passengers' Bill of Rights," to mandate the "common sense" treatment of airline travelers. Accountants use the "test of reasonableness" in reviewing financial decision-making and actions, this test being the notion that a jury of peers would draw conclusion that the decision/action was "common" in its final form.
If common sense is so common, why must it be mandated, explicitly expressed, or organizationally institutionalized? Perhaps to materialize and make "commonly" known the obvious? After all, Starbucks shut down every one of their stores for two hours, earlier this year, in order to bring order (ie., common sense) to the preparing and serving of their "common beverages." The Golden Rule of routinely expecting receipt of quality customer service, survives in theory albeit not always in practice.....I suppose that's why we (and Starbuck's employees) practice......to make perfectly common.
Posted by: Todd Wurschmidt, Ph.D., CAE | September 6, 2008 5:28 PM
Scott, clearly Carefirst customer service is paid to act, but not to think. I recently posted about a similar experience with Carefirst:
http://www.effectivedatabase.com/blog/2008/08/28/carefirst-gets-it-wrong-and-then-gets-it-right/
For many large operations like Carefirst, the metrics for customer service incentives tend to focus on doing things efficiently rather than doing things effectively. Getting "done" with your form is more important than getting it done correctly. Associations (and all businesses) need to be careful about providing incentives for behavior that negatively affects the customer.
Posted by: Wes Trochlil | September 7, 2008 10:13 AM
I work with CareFirst, but I am just a software developer. I will see if I can forward your concerns to appropriate person in claims area.
Posted by: Rahul Jain | September 7, 2008 1:25 PM
Comparing your experience to associations, I have always wondered how we affect the perception among prospective new members through their quality of customer service (positively or negatively). Our board members and other leaders are always taken care of, as does everyone else who knows the trapdoors & who to call. But ensuring that the most common member experience is a positive one requires a couple things: training/support, adequate staffing, good/logical policies (that may have to mandate common sense!), and motivated staff. There is only so much management can do with what may be very junior, perhaps demoralized staff who are handling a large volume of transactions ...
In member/audience research, I hear about the occasional "nightmare experience," although respondents with very bad experiences are unlikely to participate in many of our broad-based assessments. Staff will often react with "yeah, there were some breakdowns last year" or "we had a temp at the main switchboard who wasn't very good." It's natural to make excuses, but I think it's just as important to do as much as possible to implement systematic quality improvement efforts.
Posted by: Kevin Whorton | September 8, 2008 8:58 AM