Method and system for providing administrative support

• US 6,581,067 B1
• Filed: 09/12/2000
• Issued: 06/17/2003
• Est. Priority Date: 09/12/2000
• Status: Expired due to Fees

• Current Assignee: Uniprise, Inc. (UnitedHealth Group Incorporated)
• Original Assignee: Uniprise, Inc. (UnitedHealth Group Incorporated)
• Inventors: Schroder, Mark, Amarante, Michael C., Katagiri, Yasuhiko, Bjergo, Reed M.
• Primary Examiner(s): Coby, Frantz
• Application Number:
  US09/660,220
• Time in Patent Office: 1,008 Days
• Field of Search: 379/265.01, 379/88.14, 379/201, 345/329, 395/182.02, 709/229, 709/245, 707/104.1, 707/5, 705/5
• US Class Current: 1/1
• CPC Class Codes: G06Q 10/02 Reservations, e.g. for tickets, services or events
• CPC Class Codes: G06Q 10/10 Office automation; Time management
• CPC Class Codes: G06Q 30/02 Marketing; Price estimation or determination; Fundraising
• CPC Class Codes: H04M 3/51 Centralised call answering arrangements requiring operator intervention , e.g. call or contact centers for telemarketing
• CPC Class Codes: Y10S 707/99945 Object-oriented database structure processing
• CPC Class Codes: Y10S 707/99948 Application of database or data structure, e.g. distributed, multimedia, or image

Abstract

An exemplary embodiment of the invention is an administrative support system which provides customer support representatives the ability to respond to customer requests efficiently. The system includes a plurality of customer service workstations coupled to a host system through a network. The host system is coupled to a database and one or more legacy systems. A customer service representative at the customer service workstation can perform tasks such as searching provider information, updating eligibility and enrollment information and creating and tracking call records.

Claims

1. A system for providing administrative support to customer service representatives, the system comprising:

a customer service workstation;

a host system coupled to said customer service workstation through a network;

a database coupled to the host system; and

a legacy system coupled to the host system;

wherein a customer service representative at said customer service workstation receives a call from a requestor;

said customer service representative generates a call record based on said call, said call record includes a call type designator identifying a topic of said call, at least one call type designator identifying a topic of said call from the requestor as insurance benefits, said call record includes comments entered by the customer service representative through said customer service workstation;

said host system stores said call record in said database;

said host system searches said database for call records having a specific call type designator; and

said host system generates a call report of call records including said specific call type designator.

2. The system of claim 1 wherein:

said host system generates said report in response to a request from said customer service workstation.

3. The system of claim 1 wherein:

said host system generates said report automatically.

4. The system of claim 1 wherein:

said host system includes a network server for communicating with said customer service workstation.

5. The system of claim 1 wherein:

said host system includes an applications server for communicating with said database.

6. The system of claim 1 wherein:

said customer service workstation submits a request to said host system to update member eligibility information; and

said host accesses said database and stores updated member eligibility information.

7. The system of claim 6 wherein:

said customer service workstation submits a request to said host system to update member enrollment information; and

said host accesses said database and stores updated member enrollment information.

8. The system of claim 1 wherein:

said customer service workstation submits a request to said host system to obtain provider information; and

said host accesses said database and locates provider information.

9. The system of claim 8 wherein:

said host system provides said provider information to said customer service workstation.

10. The system of claim 9 wherein:

said provider information includes provider address.

11. The system of claim 9 wherein:

said provider information includes provider contracts.

12. The system of claim 9 wherein:

said provider information includes provider affiliation.

13. A system for providing administrative support to customer service representatives, the system comprising:

a customer service workstation;

a host system coupled to said customer service workstation through a network;

a database coupled to the host system; and

a legacy system coupled to the host system, said legacy system including an insurance benefits and eligibility system, an insurance billing system;

an insurance claims information system and an insurance provider information system;

wherein a customer service representative at said customer service workstation receives a call from a requestor, said customer service workstation accessing at least one of said insurance benefits and eligibility system, insurance billing system, insurance claims information system and insurance provider information system in response to said call;

said customer service representative generates a call record based on said call; and

said host system stores said call record in said database.