One of the programs we used very effectively at Express Scripts to test our call center was a “mystery shopper” program. Much like the name implies and has been used in retail for years, this process had a person calling into the call center and asking a series of questions about plan design or other aspects. This was a great way to see if training had worked and understand the experience that our members had.
I honestly don’t remember exactly how we set this up to pass the authentication process, but I believe we probably created “dummy” members in the eligibility file with a name and member ID that could be used by the mystery shopper.
Those calls were then ranked based on quality of response, consistency of response, first call resolution, and other aspects. This testing process was continued until the quality scorecard passed a certain level.
With the increasing complexity of plan design, this is something that everyone should look at.
Maybe it would have been more helpful if you had used actual members who are mystery shoppers. I myself have been Gold Certified for several years and would love to have been one of the ones to have placed a call to Express Scripts. I have done this in a real life situation and almost said to them, “You should be thankful I am not a mystery shopper.”