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What an omnichannel payer organization looks like in practice

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The digital age has dramatically changed how service companies interact with their members. Thanks to digital-native companies like Amazon, Google, and Spotify, consumers have gotten a taste of the speed, convenience, and personalization offered by digital and live-person channels.


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In response, numerous industries are launching large-scale omnichannel communications. Banking and telecommunications, for example, have widely adopted digital service channels that connect with members through AI-enabled chatbots and virtual assistants. These new channels give members the convenience of support without waiting in line for an in-person conversation.

However, healthcare payer organizations have often lagged behind other sectors in providing omnichannel experiences. Although many payers offer online services, most members still prefer traditional channels because digital contact solutions are inadequately developed.

Some payers argue that the nature of their business makes it impossible to deploy unified communications platforms, but this cannot be further from the truth. The industry has payers whose omnichannel experiences rival those of leading digital-native companies.

This article unravels the outlook of an effectively functioning omnichannel organization and gives you pointers on building omnichannel capabilities for superior member service. You will learn:

What do omnichannel payer organizations look like?

The typical member journey involves multiple business units. For payers, these different touchpoints can include brokers, adjusters, appraisers, and member support agents. Consequently, managing the journey from end to end is often subject to friction. The usual issues include lack of collaboration between parties, information silos that undermine team and process integration, and a rigid service approach that does not steer members toward the appropriate platforms.

Omnichannel communications help payers create a frictionless member journey by enabling them to handle requests efficiently using the right platform while reducing member service costs. Payers with omnichannel contact strategies benefit from lower operational expenses, higher member satisfaction, and an all-around effective, motivated support staff.

If you are considering an omnichannel member service approach, you can make the transformation easier by learning from payers who have already succeeded. Read on for three notable characteristics of omnichannel payer organizations.



The primary purpose of omnichannel communications is to make member support efficient, cost-effective, and relevant. Successful payers establish key performance indicators that measure how business units contribute to enhanced member experience.

Measuring omnichannel execution is best achieved through standardizing member feedback mechanisms across all channels and linking them to management incentives.

Payers also introduce KPIs that speak directly to omnichannel targets. These KPIs measure metrics like member contact documentation efficiency and first contact resolution rate.



Omnichannel implementation requires the optimization of members-related working practices. For example, some payers permit top-value members to call specific business unit employees at any time. While this practice gives high-priority members unlimited agent access, it also increases employee interruptions, lowering productivity.

In the example above, a payer that succeeds in omnichannel implementation could set up a virtual response system that requests all members to reveal their reason for calling before transferring them to an agent. Low-complexity tasks can be handled by your contact center, regardless of the member making them, leaving business unit employees to handle rare, unit-specific requests.



Omnichannel effectiveness heavily relies on collaboration across business units. Therefore, in omnichannel payer organizations, all departments work on a shared IT platform with a standard, comprehensive database.

To optimize member experience during interactions, omnichannel payers set up cross-functional teams responsible for end-to-end member service. This approach breaks down data silos and enhances effective collaboration.

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How can you become truly omnichannel?

Omnichannel transformation is typically a challenging, large-scale, long-term program with a diverse team of stakeholders. However, considering the benefits, you owe it to your organization to make the change. The following are three tips for implementing omnichannel member service.



Goal setting is a critical aspect of any transformative change, and omnichannel is no exception. Omnichannel goals are usually defined in three phases:

In the first phase, your goals need to drive the effective adoption of digital channels and newer communication forms like chat and co-browsing.

Once the proper channels are in place, set new goals to ensure service consistency across the board. Consistency prevents the possibility of members receiving inchoate or contradictory information on different channels.

As soon as coherence is in place, proceed to omnichannel integration. Establish goals that enable seamless interaction as member interactions move from one platform to the other.



Omnichannel service goes far beyond merely establishing new technologies. It also requires a robust change management plan that encourages employees and members to embrace omnichannel tools while ensuring the seamless integration of siloed functions.

Your change management approach must steer stakeholders effectively to omnichannel contact solutions through effective communication and training sessions that blend project goals with long-standing company culture.



Depending on your starting point, the omnichannel journey can be long. Building the necessary IT platforms and the capability required to utilize them fully can take time. Therefore, it is critical to establish clear prioritization early on and focus on the end-game while plucking low-hanging fruits along the way.

Your plan must strike the right balance between making high-value investments that drive short-term returns and building a foundation for long-term success.

RingCentral can help you achieve your omnichannel goals

You can make omnichannel transformation significantly easier with the right solutions. RingCentral is your one-stop shop for comprehensive, intuitive solutions that enable seamless member contact through multiple channels. With RingCentral, your support staff can access the same digital tools through a single, user-friendly, all-accessible unified communications platform that is easy to deploy and integrate with existing infrastructure.

Request a demo today to discover how our unified communications platform can make your omnichannel journey a success.

Originally published Oct 05, 2021, updated Oct 04, 2021

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