Navigating the Complexities of Medicare as a Trusted Guide

A health maintenance organization (HMO) wanted more insight on why they weren’t converting leads to opt into their Medicare Advantage Plan.  

Authenticx in Action 

Authenticx analysts evaluated 161 sampled calls. Of those calls most callers were ‘potentially insured’ prospects (78%) who were seeking information about Medicare.  

The top 3 reasons for calling were all focused on education:  

  • Policy Coverage Info  
  • General Medicare Info  
  • Eligibility Questions  

The potentially insured callers are often seeking a trusted advisor rather than a salesperson due to the complexity of the program. Examples of call dialogue was often along the lines of: 

“I’ve never been on Medicaid or Medicare. I don’t know anything about it.”  

Medicare is complicated, and this analysis found agents do an excellent job of being trusted advisors and consultants to help understand the complex Medicare process. However, they fall short on summarizing, offering a follow-up call, and emphasizing the differences between their Advantage Plan and that of competitors. 


These insights highlighted opportunities to:  

  • Strengthen the agent-customer relationship by paraphrasing or summarizing what was discussed at the end of the call to ensure callers feel heard and understood 
  • Develop consistent practices of scheduling follow-up calls 
  • Equip agents to explain brand value differentiators between their Medicare Advantage Plan and that of their competitors 


Authenticx in Action | On-Demand Video

See Authenticx in Action

Learn more about how Authenticx analyzes customer conversations to surface recurring trends in this two-minute video.

About Authenticx

Authenticx was founded to analyze and activate customer interaction data at scale. Why? We wanted to reveal transformational opportunities in healthcare. We are on a mission to help humans understand humans. With a combined 100+ years of leadership experience in pharma, payer, and healthcare organizations, we know first-hand the challenges and opportunities that our clients face because we’ve been in your shoes.

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