Home
Trends
Recognitions
Academy
About Mosaic
“There are so many hoops I have to jump through to get my claims reimbursed. I really don't like it.”
Through feedback from the Customer Enthusiasm Monitor and Member Services call volume data, we identified that members experience a disconnect when they file a claim. From questions on filling out the claim form, uploading supporting documents, waiting to find out if their claim was received, understanding their explanation of benefits, and receiving reimbursement, there are many areas of this journey that can create a disjointed experience and delay results to our members.
Our members want a more effortless claims experience with less need to contact Nationwide for help or to explain things. “I really wish your communication was better on claims because I think I could have gotten my answer without having to call in.”
After completing the journey mapping experience, we learned that better communication to our members could be enabled by enhancing the portal so members have visibility into the status of their claims payment and an immediate reassuring communication that their claim has been received and next steps.
Our members want a more effortless claims experience with less need to contact Nationwide for help or to explain things. “I really wish your communication was better on claims because I think I could have gotten my answer without having to call in.”
After completing the journey mapping experience, we learned that better communication to our members could be enabled by enhancing the portal so members have visibility into the status of their claims payment and an immediate reassuring communication that their claim has been received and next steps.
Working on improvements within the claims journey helps build trust and value with our members. Our customers are advocating for their furry, scaly, and feathery babies to provide them support and resources to live healthy and happy lives.
During a time that can be stressful, having a reassuring claims experience, one in which our members feel confident in the information they submitted and knows what to expect so there is limited opportunity for surprises, is what it means for us to be reassuring. If our members can quickly submit and feel confident about what they submitted, they can get back to caring for their pet.
Their pet’s quality of health is of the utmost importance and making timely decisions about their pet’s care is vital. Worrying about whether they submitted something right or what may be covered is the last thing our members want to worry about.
A quick and easy claims process can contribute to retention, especially with new members. When a member is submitting a claim for the first time, their first impression can determine how they view the value of our service. An improved claims experience can help reduce call volume due to common issues with claims submissions.
As we continue through our CX transformation on our file a claim journey, we hope to reduce claims calls per PIF in Pet Member Care to less than 1.05%. We also hope to reduce effort and expenses for our claims department by decreasing re-reviewed claims denied for basic issues.
