Wisconsin Physicians Service Insurance Corporation
Wisconsin Physicians Service Insurance Corporation (WPS), headquartered in Madison, Wisconsin, is the largest claims-processing and customer service provider to Medicare beneficiaries in the United States. Customers served reside in the states of Wisconsin, Illinois, Michigan and Minnesota. Additionally, WPS is one of the largest private health insurers and administrators in Wisconsin, providing private health plans, agency services, technological expertise (through its subsidiary External Technology Services) and other insurance products (through its EPIC Life Insurance Company subsidiary).

Challenge
Over the past three years, WPS has acquired additional Medicare contracts to provide claims processing and customer service support for beneficiaries, which significantly increased the work volume and complexity of their operation. The technology platforms in these facilities were diverse, antiquated and not scalable for their business objectives. As a result, WPS needed to invest in new telephony and contact center solutions for the Illinois, Wisconsin and Michigan facilities.

WPS selected The Customer Group, LLC. to assist in this effort for its expertise in:

• Customer Center Architecture
  
  
• Customer Cost Management
  
  
• Customer Interaction Insights
  
  
• Enabling Customer Technology Solutions
  
  
• Customer ROI
  
  
• Project Management

Approach
The Customer Group was initially engaged to assess the capabilities of the existing facilities, determine WPS's needs, define the requirements of the organization, facilitate the selection process, develop cost models and coordinate initial implementation planning activities. The Customer Group prepared a comprehensive implementation plan involving over 1,000 employees across four states and developed a Request for Proposal delineating the specifications for technological and operational components. The selection and evaluation process for a replacement telephony platform was developed and managed by The Customer Group in close collaboration with WPS. The Customer Group performed detailed functionality evaluations, project team assessments and developed detailed cost models for evaluation and tracking purposes. Using the results of this effort, WPS selected the vendor, negotiated a contract for implementation, and began implementing the new technology on a phased, regional basis.

The Customer Group was further engaged during the first regional rollout to monitor contractor performance and assess delivery against requirements. Additionally, The Customer Group developed a series of contingency plans for future phases of implementation and a comprehensive test protocol for use by WPS to ensure that the Interactive Voice Response (IVR) system, which is the cornerstone of the system from the customer's perspective, performs according to design. This engagement is ongoing and focuses on performance reporting, implementation oversight, troubleshooting and operational reengineering to ensure maximum utilization of resources.

Result
Using the results from the initial The Customer Group consulting engagement, WPS selected a premier telephony solution that provided a mix of functionality and value while meeting their objectives for future growth. The requirements of the Medicare program for claims processing and customer service to their beneficiaries have also been met.

In follow-on work completed to date, The Customer Group has assisted WPS in stabilizing the first regional IVR implementation, identified contingency plans for future phases and developed a comprehensive test protocol for the IVR. This effort has substantially reduced the risk to WPS in implementing the platform across other regions.