Client liaison officers brings medical scheme closer to its members

GEMS further improves services to remote regions of SA

In a bid to further enhance the accessibility of its services to its members, the Government Employees Medical Scheme (GEMS) is establishing a number of special client liaison offices (CLOs) throughout South Africa (SA), particularly in the more remote areas of the country.

Commenting on this development, Liziwe Nkonyana, Executive: Communications and Member Affairs of GEMS says that SA’s second largest medical scheme now provides healthcare cover to approximately 1.8 million individuals in all nine provinces, many of whom are situated in rural or semi-rural areas of the country.

“We believe it is critical to be on hand to render services to all of our members and potential members, including those situated in the more the inaccessible areas of the country. We would like our members to be able to communicate with the Scheme with absolute ease when it comes to obtaining more information on benefits or in the event of any difficulties.”

According to Nkonyana, these are just some of the reasons why the Scheme has embarked on an initiative aimed at setting up a network of client liaison offices throughout SA.

“One of the key roles of this unit is to expand the GEMS footprint, and to improve our ability to serve the needs of our members while strengthening and opening up new channels of communication with our valued members. The CLOs support and complement the services currently offered by the GEMS call centre and walk-in centres,” she explains.

Nkonyana says that the Scheme’s specially trained CLOs are tasked with attending to and resolving member queries while providing feedback to members and the Scheme. It is also the duty of the CLOs to escalate any outstanding matters to ensure resolution. The staff within the unit is responsible for improving the current turnaround times of queries and will work on a 70% onsite resolution target requiring instant feedback to ensure enhanced member satisfaction.

“The CLOs will handle all correspondence originating from the members in their regions, whether these are complaints, enquiries or compliments. These staff members are dedicated to the timeous resolution of service-related complaints and are there to assist members who are dissatisfied with their access to GEMS services.”

“To ensure that all the members are kept fully up-to-date with the latest service and benefit offering from GEMS and to encourage members to get to know more about the Scheme and its benefits, the CLO unit will arrange special member education workshops. We regard it as absolutely essential that our members have a complete understanding of their benefits so that they are able to derive maximum benefit from them.”

“The CLOs will serve as a vital link between the Scheme, the service provider network and the members. They will play a critical role in member retention by ensuring that members receive the necessary assistance, in the language of their choice, at key contact points.

Member insights will furthermore be used to help shape some of the Scheme’s decisions with regard to benefit design while further driving the member-centricity of the GEMS.”

According to Nkonyana, the CLO division also supports the acceleration of member enrolment by assisting potential members to obtain, complete and submit the necessary membership documents.

“The client liaison officers are our representatives, our ‘foot soldiers’, on the ground, taking GEMS’ services even further into the communities of South Africa. The CLO concept is a novel one for the medical schemes industry, and we have already received a great deal of positive feedback from our members on the work that is being done by the team. In the next few years we will be looking to expand the presence of CLOs wherever our members are to be found,” concludes Nkonyana.