Should health plans consider outsourcing contact center work to an experienced partner?

When the North Dakota Medicaid Expansion Managed Care Organization (MCO) contract was awarded to Blue Cross Blue Shield of North Dakota (BCBSND) in June of 2021, they turned to Noridian Healthcare Solutions for help with serving members in their contact centers. Why? Because BCBSND recognized outsourcing this specific area to an experienced partner was essential in ensuring North Dakotans received the best possible customer experience when asking questions about their Medicaid benefits, claims and more.

“Every day, Blue Cross Blue Shield of North Dakota aims to help North Dakotans navigate the complexities of health care through our various lines of business, including Medicaid. However, we understand collaboration is key to making this a reality which is why we turned to Noridian for help,” says Chelsey Matter, executive director of government programs at BCBSND. “Noridian’s contact center experience made it a successful partnership from the start and the high quality of work continues to this day. Like us, they want to enable access to care for everyone and we are doing it together for the residents of North Dakota.”

Noridian’s reputation as a high-quality contact center partner is a result of nearly 60 years handling health care related inquiries including those regarding Medicare. In fact, Noridian’s over 2,000 employees support more than 370,000 providers, 50,000 durable medical equipment (DME) suppliers and 7,000 facilities across all 50 states and several U.S. territories. In 2023, Noridian’s experienced contact center staff handled nearly 2 million inquiries. What’s even more impressive is Noridian’s ability to consistently exceed quality goals set forth by Centers for Medicare & Medicaid Services (CMS) for all Medicare contracts. This is due our customer first training philosophy, remarkable employees and leadership.

Noridian’s experience was invaluable to BCBSND because contact center work is not easy and requires a specific skillset that is necessary to give the caller a positive experience. The work becomes especially complex when you add the unique challenges facing the Medicaid population which includes many of the most vulnerable. Calls extend beyond general questions about coverage and available benefits to inquiries about claims and helping members navigate situations where they are receiving bills for services provided. Additionally, Noridian reviews, approves, and coordinates transportation, meals, and housing for members who request those services.

Noridian employees help members navigate the complexities of the system so they have access to quality health care, even when they may not have a consistent place to live or know where their next meal is coming from. As a result, emotions run high during many of the calls which is why Noridian invests in specialized training to ensure its staff is equipped to empathetically handle sensitive situations in a timely manner. Our employees understand Medicaid benefits are critical to members’ wellbeing.

Although most of the calls come from Medicaid members, providers also inquire about claim denials, appeal status and eligibility. As a result, team members are trained to be well-versed in all aspects of North Dakota’s Medicaid program so inquires can be solved quickly. This allows providers to get back to doing what they care about most — providing quality health care to their patients.

“Our Noridian team understands that successful call center operations require a combination of expertise, efficiency, and empathy. Our customer service representatives strive for an elevated customer experience for every call,” says Peter Limvere, manager of operations for the ND Medicaid Claims Call Center.

Since the contract started in January of 2022, Noridian has handled more than 80,000 provider and members calls with customer service quality scores exceeding 99% and 100% of the service-level agreements (SLAs) met since May 2022. In addition to this contract and the Medicare contracts, Noridian also supports contact center work for North Dakota Medicaid claims and provider enrollment.

“Noridian understands the experience we provide to those who call into our contact centers could potentially have major impacts on their lives. Therefore, our impact is bigger than just handling a call or responding to an inquiry – it can enable access to care,” says Anne Simon, VP of customer experience at Noridian.  “We take that responsibility very seriously which is why we’re committed to doing everything we can to providing the best possible experience for our customers’ members.”

If you are a health plan facing contact center work challenges, or other operational challenges, such as provider credentialing or medical management, please Contact Us. We’d love to learn more and discuss if there’s an opportunity to work together.