CorpshoreBPO · Santo Domingo
Member services for a United States regional health plan
The challenge
The plan needed HIPAA-aligned member services at a cost it could sustain, and its compliance function had blocked offshore delivery twice. Speed of answer, annual-enrolment abandonment and repeat contact on claims status were all weak, and the plan needed a partner whose privacy controls its own officers could physically verify.
Approach and methodology
- Trained and measured agents on a complete-answer protocol, not status-code reading
- Rebuilt quality scoring around completeness of disposition
- Established a compliance lead within the account and HIPAA-aligned handling
- Used the two-hour flight from Miami so the privacy officer could audit the floor in person
Results
Average speed of answer fell from 412 to 62 seconds, annual-enrolment abandonment fell from over 30% to 6.4%, and first contact resolution rose from 61% to 89%. Member satisfaction reached 96% and the operation recorded zero HIPAA-related audit findings. Nearshore proximity, not a document, is what changed the compliance function's position.
-68%
repeat contact rate, claims status
0
HIPAA-related audit findings
2 hrs
flight from Miami for on-site audit
| Metric | Baseline | Latest | Change |
|---|---|---|---|
| Average speed of answer | 412 s | 62 s | -85% |
| Abandonment, annual enrolment | > 30% | 6.4% | -79% |
| First contact resolution | 61% | 89% | +28 pts |
| Member satisfaction | 82% | 96% | +14 pts |
| HIPAA-related audit findings | n/a | 0 | Zero findings |
Our compliance function had blocked offshore twice. What changed their position was not a document, it was the fact that our privacy officer could fly to the site, walk the floor, and be back the same day.
Enduring value
The complete-answer protocol and completeness-based quality model are now the plan's standard for member services, and the nearshore audit access remains a standing part of the compliance relationship.
Client identities have been anonymised. Industry, size, geography, delivery site, service scope and reported outcomes are presented as they occurred, with identifying detail removed at client request or under confidentiality provisions. Where a figure originates from a client's own internal modelling rather than a jointly measured metric, that is stated in the text and the figure is not presented as a Corpshore claim. Treat these outcomes as directional benchmarks; Corpshore Dominicana produces engagement-specific projections during discovery.
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