Valuable and Invisible: The Challenges and Benefits of Getting Customer Communication Management Right (Part I)

How an organization sends information to and receives information from its customers has a profound effect on its overall success. From market share and customer satisfaction, to print and mail spend and call center efficiency, customer communication management (CCM) is something that’s absolutely vital to the success of an organization, while at the same time nearly invisible to everyone involved.

Let’s take a look at some the reasons for this. Figure 1 lays out the main factors contributing to CCM’s value and invisibility.


Figure 1 – CCM Value Versus Invisibility

All this is good in the abstract, but given how invisible CCM tends to be at an organization, let’s jump right in to a concrete example to make CCM a little more visible.

A Health Payer Example: Explanation of Benefits

A good example of how CCM’s value and invisibility combine to create huge problems for an organization would be a health payer’s explanation of benefits (EOB) letter. EOBs are incredibly important to a health payer’s customers (the insureds) because they tell them what insurance covered and what it didn’t (and therefore what they need to pay out of pocket). But EOBs are also incredibly important to health payers themselves, not only because they’re one of the primary ways a health payer communicates with its customers, but also because payers send lots and lots of them out (and spend huge amounts of money doing so).

Given all this, EOBs can drive huge value for payers if they’re done right, and they cause huge problems if they’re done wrong. From hours of inefficient work during the design, production, and delivery of EOBs, customer service churn when insureds call in with questions or problems with their EOB, to dealing with regulatory and compliance issues caused by incorrect or misleading EOBs – getting EOBs wrong can cost a payer tremendously in time, money, and ultimately market share.

So what would doing EOBs right look like?First, designing the EOB to be clear, readable, and compelling, but also to require the least amount of handling and postage and to be suitable for multi-channel delivery. Next, you need to be able to get the right data into each EOB quickly and accurately and generate the finished product (whether print or electronic, or both). Then, you need to deliver the EOB to the insured in the format they want it and keep a record of it so that customer service agents can see what the insured sees during a call to solve any issues the insured might have.

But as simple as this may sound, it’s phenomenally complex in practice – which might not be a shock to you if your payer hasn’t gotten their EOB act together and you’ve been on the receiving end of poor EOBs! To get EOBs right in the way I’ve described, a payer would, first, need to find an owner for the efforts, and typically no single person owns EOBs:

  • Marketing owns parts of the template
  • Regulatory compliance owns other parts of the template
  • IT owns the systems that hold the EOB data, generate the EOBs, and store the electronic versions of the EOBs that are sent out
  • Claims owns the EOB data
  • Membership owns the insured data
  • Operations owns the printing and mailing of the EOBs, whether internally or via a managed services vendor
  • Customer service is responsible for servicing the EOBs when insureds have questions or problems

As you can imagine from this list, the payer that wants to reap the benefits of getting EOBs right and avoid the problems caused by getting them wrong has a serious challenge in front of them. They need to get all of these stakeholders to:

  1. Acknowledge the problems caused by poor EOBs
  2. Agree that the organization should pay to fix them
  3. Decide who’s going to pay the bill
  4. Agree to work together to solve them
  5. Actually work together and solve them
  6. Commit to ongoing involvement to make sure they keep doing EOBs right without slipping into their old bad habits

Doing all this is extremely difficult for all the reasons presented on the right side of Figure 1, but it’s also mission-critical to achieve, for all the reasons presented on the left side of that same figure.

The Final Word

Okay, so much for the problem. At this point, I’m hoping you have a better understanding of why CCM poses such a challenge for organization, as well as for why CCM holds out so much opportunity for creating value. In the next post, we’ll step through some ways that an organization can address these challenges to get the value CCM promises.

Rich Medina
Joe Shepley
I’m VP and Practice Lead, focusing on developing Doculabs’ InfoSec practice and its applications in a wide range of industries.