Nearly every claim, member service, or health service project we do involves an interactive voice response problem. So we have a lot of practical experience with IVRs—the good, the bad, and the ugly.

IVRs stand between a health plan's clients and the plan's ability to provide service. Usually, IVR helps callers get the service they need. But let's be honest—in too many cases, IVR doesn't help. It's an irritating speed bump or a road block to service. We all know the symptoms of a bad IVR system: long menus, long delays, confusing menus, mis-routings, and the need to call back.

Recently, I had occasion to review Nolan's experience with IVR problems and design issues. It was eye-opening. At the start of my research, I thought I had a good intuitive sense of what I would find. I was right. What I expected to find in terms of problems, symptoms, and corrective actions was quite close to what I found.

But, when it came to the underlying design issue, I was wrong. If forced to bet on the most common design flaw, I would have put my money on having the selections in the IVR menus in the wrong order. By "wrong order" I'm referring to menus whose sequence doesn't reflect the frequency of the types of incoming calls (most common call type first, second most common next, and so on). But I would have lost my money.

The most common design flaw was even more fundamental. It was, as it turns out, combining business-to-business calls with consumer-to-business calls. We've all heard it: "Welcome to Slow Service Health Plan. If you are a provider, press 1. If you are a member, press 2." In this design, we are doing something that is stunningly silly. We mix provider and member calls together by our routing, then force callers to sort themselves out so we can talk to them! This deeply flawed design error leads to long menus, long delays, confusing menus, mis-routings, and abandoned calls.

Is your health plan making this error? Test call your IVR. But before you do, make a bet with yourself—you might be surprised. The good news is that an advantage of betting with yourself is that you nearly always win.