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Wherever You Are and Whatever It Takes

The call seemed routine: A member named Joanna was looking to resolve some issues that were preventing her from getting her nebulizer treatment from the hospital. But Brittany Salter, the Aetna customer service representative who handled the call, sensed it was more critical than it sounded.

”When you do the job for a while,” said Kimberly Kinnish, a 17-year Aetna veteran and Salter’s former supervisor, sometimes “you can tell just from the tone” that something is wrong.

That’s what Salter sensed, and so she worked urgently. She validated Joanna’s information. She said she’d get assistance from Aetna’s pharmacy area. And she was getting ready to call the pharmacy herself when Joanna suddenly told her something else.

Joanna told Salter that she couldn’t breathe.

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As a company built on customer service, Aetna has pushed the limits of traditional service boundaries to make sure we give members a better experience. We call it Service Without Borders—the message from Aetna to our employees that they are empowered to do what they need to do to take care of our members, even if it doesn’t officially fall under their job description.

Service Without Borders is just one prominent piece of Aetna’s larger mission to think beyond the traditional boundaries of health care, looking at all the factors that affect a person’s health, like transportation and housing and nutrition. Other pieces—Resources For Living®, multidisciplinary care teams, Healthy Community grants—follow the same path. They’re not just programs; they’re statements of our commitment to put our members at the center of everything we do. We want to understand them, understand how and where they live, understand how to address their holistic well-being. We want to make sure we invest as much time and effort into keeping them healthy as we do in helping them access quality care when they’re sick.

Aetna’s customer service representatives take the mission seriously.

Service Without Borders had a significant impact on the day-to-day and was an especially important factor in why I was so adamant about helping Joanna,” said Salter, who has worked for Aetna for two years. Her voice rose and quickened as she spoke with escalating passion. “That call went so far beyond our typical calls that we handle. I just knew more needed to be done and I had to focus on our member and what they needed.

For her actions, Salter received the Aetna Way Excellence Award (AWEA). AWEA is a company-wide awards program that lets Aetna employees recognize their peers for making a difference and providing a positive experience for members, plan sponsors or fellow employees.

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“I could hear her trying to breathe, struggling to breathe,” Salter said, recounting that March 6, 2017 phone call. “The TV was on.”

Salter asked Kinnish, her supervisor, for help. Kinnish also has taken Service Without Borders to heart. She has a note on her desk from an employee meeting, a standard for meas­uring our response to members: “Would I be satisfied with the answer if it was being said to me?”

“I try to make sure my team knows that, as well,” Kinnish said. “Try to relate to what’s going on and do what we can for them because that’s what matters. Members are true people. They aren’t calling just because they want to say hello.”

Salter and Kinnish both realized they needed to get in touch with the local authorities. But the member’s plan had only a PO box, not an address. They knew time was escaping. They tried not to panic. But, Salter conceded: “It was crazy.”

Kinnish told Salter to keep checking on Joanna, telling her they were there for her. The two scrambled through the member’s information and finally found an address. They also found a number for local authorities. They called and told them to send help.

They had no idea if it was enough. Or if it was in time.

“She said she couldn’t breathe and now she’s not responding,” Kinnish said. Separated by nearly 3,000 miles, connected only by phone, they couldn’t help but wonder: “Is she laying there dying?”

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Aetna is a large company with nearly 50,000 employees serving more than 37 million people, but its success lies with each one of those employees caring about each one of those people on a very personal level.

Service Without Borders makes sure the customer service representatives have the right information they need to take care of those members quickly. Aetna has set up lifelines for customer service representatives to reach out to specific areas of the organization like pharmacy, pre-certification, appeals, claims; to have instant access through IM; to have even more information at their fingertips through partnerships made across the company. These, and other resources work to keep the phone conversations shorter, more complete and more effective for members.

Salter admitted that sometimes a customer service representative can feel “small” in a large organization. But both she and Kinnish agreed that they feel empowered to make critical decisions, knowing they’ve got the backing of management and the company.

You don’t always see yourself as someone who’s going to make a difference,” Salter said. “You just do everything you can on each and every call. You don’t think of yourself as a ‘hero,’ but when something like this comes up—you just spring into action.

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After talking to local authorities, Salter took a moment to compose herself and gather her thoughts. But she couldn’t focus. She knew she wouldn’t be able to focus until she knew what happened to Joanna. She called back.

There was no response.

“I couldn’t have peace of mind if no one answered,” Salter said.

Common Purpose:
Advocate for our members’ best health by helping them get the most from their benefits, building trust, and always providing a clear path to care.

She called a second time.

This time, the member’s daughter picked up the phone, and told her that an ambulance had arrived.

A month later, Joanna called the customer service line to thank Salter for saving her life.

For her actions, Salter received the Aetna Way Excellence Award (AWEA). AWEA is a company-wide awards program that lets Aetna employees recognize their peers for making a difference and providing a positive experience for members, plan sponsors or fellow employees.

Kinnish said their shared experience was a real “eye-opener.” And it emphasized to both women just how much of an impact they can have on members.

“Each member is a person and they may have other issues that you may be able to pick up on if you listen,” Salter said. “We’re more than just customer service representatives. We’re people who should be sympathetic to the other
person on the phone.”

“We do make a difference,” Kinnish said. “This was really something that Brittany will always take with her. She’ll be able to always say, ‘I made a difference.’”

Next Next: Mental Health

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