Ready to beginBastion HMO: WhatsApp, Omnichannel & AI Customer Engagement Discovery Pulse
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Bastion HMO business and technology stakeholders

Bastion HMO: WhatsApp, Omnichannel & AI Customer Engagement Discovery Pulse

A structured discovery pulse covering member journeys, operations, technology, integration, automation, security and implementation priorities.

Please answer from your area of responsibility. Where information is not currently available, enter “To be confirmed.” Your responses will inform the customer experience, WhatsApp, omnichannel, CRM, integration, automation, AI, reporting, security and delivery recommendations.

191 questionsProgress shown as you go

Before you begin

Tell us who is responding

These details will be stored with your response.

01

Section 1

Contact & Context

Tell us who is coordinating this response.

01  ·  Contact & Context

Role / department*
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02  ·  Contact & Context

Telephone number
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02

Section 2

1. Business Objectives

Clarify the outcomes the proposed service must deliver.

03  ·  1. Business Objectives

What are the primary objectives for the proposed solution?
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04  ·  1. Business Objectives

What are the three most important outcomes expected from this initiative?*

List the outcomes in priority order.

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05  ·  1. Business Objectives

What would success look like 6–12 months after implementation?*

Consider call volumes, response times, digital enrolments, sales, renewals, satisfaction and self-service.

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03

Section 3

2. Customers, Members & Stakeholders

Understand the audiences, channels, volumes and reasons for contact.

06  ·  2. Customers, Members & Stakeholders

Who should be able to interact with the proposed service?
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07  ·  2. Customers, Members & Stakeholders

Which channels are currently used for member / customer engagement?
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08  ·  2. Customers, Members & Stakeholders

Approximately how many enquiries are received through each channel, and which team is responsible?

Cover WhatsApp, telephone, email, website/live chat, social media, member portal/app and any other channels. Include whether figures are daily or monthly.

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09  ·  2. Customers, Members & Stakeholders

What are the most common reasons members or prospective members contact Bastion?*

List approximately ten reasons.

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04

Section 4

3. Current WhatsApp & Meta Environment

Establish the current WhatsApp Business and Meta infrastructure.

10  ·  3. Current WhatsApp & Meta Environment

Does Bastion currently use WhatsApp for member / customer communication?
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11  ·  3. Current WhatsApp & Meta Environment

If WhatsApp is currently used, how is it used?
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12  ·  3. Current WhatsApp & Meta Environment

Is there currently a dedicated Bastion WhatsApp business telephone number?
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13  ·  3. Current WhatsApp & Meta Environment

What is the number and its current purpose, if applicable?
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14  ·  3. Current WhatsApp & Meta Environment

How is the WhatsApp number currently operating?
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15  ·  3. Current WhatsApp & Meta Environment

Does Bastion have an existing Meta Business Portfolio / Business Manager account?
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16  ·  3. Current WhatsApp & Meta Environment

Has Meta Business Verification been completed?
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17  ·  3. Current WhatsApp & Meta Environment

Does Bastion already have a WhatsApp Business Account (WABA) within Meta?
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18  ·  3. Current WhatsApp & Meta Environment

Who currently administers the Meta / WhatsApp environment?
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19  ·  3. Current WhatsApp & Meta Environment

What is the WhatsApp number currently integrated with?
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20  ·  3. Current WhatsApp & Meta Environment

Please specify the integrated platforms.
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21  ·  3. Current WhatsApp & Meta Environment

Are approved outbound WhatsApp message templates already in use?
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22  ·  3. Current WhatsApp & Meta Environment

Should the engagement include setup, configuration or migration of the WhatsApp Business environment?
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05

Section 5

4. Current HMO Member Journey

Map the journey from enquiry through onboarding and renewal.

23  ·  4. Current HMO Member Journey

How does an individual currently become a Bastion member?*

Describe enquiry, plan selection, registration, payment, verification, member creation, activation and onboarding.

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24  ·  4. Current HMO Member Journey

What is the current digital maturity of “Plan discovery”?
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25  ·  4. Current HMO Member Journey

What is the current digital maturity of “Plan comparison”?
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26  ·  4. Current HMO Member Journey

What is the current digital maturity of “Quotation”?
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27  ·  4. Current HMO Member Journey

What is the current digital maturity of “Registration”?
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28  ·  4. Current HMO Member Journey

What is the current digital maturity of “Dependant registration”?
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29  ·  4. Current HMO Member Journey

What is the current digital maturity of “Document collection”?
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30  ·  4. Current HMO Member Journey

What is the current digital maturity of “Payment”?
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31  ·  4. Current HMO Member Journey

What is the current digital maturity of “Payment confirmation”?
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32  ·  4. Current HMO Member Journey

What is the current digital maturity of “Member creation”?
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33  ·  4. Current HMO Member Journey

What is the current digital maturity of “Member ID generation”?
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34  ·  4. Current HMO Member Journey

What is the current digital maturity of “Activation”?
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35  ·  4. Current HMO Member Journey

What is the current digital maturity of “Welcome / onboarding”?
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36  ·  4. Current HMO Member Journey

What is the current digital maturity of “Renewal”?
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37  ·  4. Current HMO Member Journey

Where are the biggest delays, manual interventions or customer frustrations within the current journey?*
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06

Section 6

5. Priority WhatsApp Journeys

Identify which journeys belong in phase one and which should follow later.

38  ·  5. Priority WhatsApp Journeys

What priority should be assigned to “General HMO FAQs”?
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39  ·  5. Priority WhatsApp Journeys

What priority should be assigned to “Explore health plans”?
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40  ·  5. Priority WhatsApp Journeys

What priority should be assigned to “Compare health plans”?
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41  ·  5. Priority WhatsApp Journeys

What priority should be assigned to “Receive plan recommendation”?
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42  ·  5. Priority WhatsApp Journeys

What priority should be assigned to “Request quotation”?
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43  ·  5. Priority WhatsApp Journeys

What priority should be assigned to “Speak with sales”?
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44  ·  5. Priority WhatsApp Journeys

What priority should be assigned to “Register as new member”?
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45  ·  5. Priority WhatsApp Journeys

What priority should be assigned to “Register dependants”?
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46  ·  5. Priority WhatsApp Journeys

What priority should be assigned to “Upload enrolment documents”?
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47  ·  5. Priority WhatsApp Journeys

What priority should be assigned to “Make payment”?
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48  ·  5. Priority WhatsApp Journeys

What priority should be assigned to “Confirm payment”?
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49  ·  5. Priority WhatsApp Journeys

What priority should be assigned to “Check enrolment status”?
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50  ·  5. Priority WhatsApp Journeys

What priority should be assigned to “Retrieve member ID / details”?
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51  ·  5. Priority WhatsApp Journeys

What priority should be assigned to “Find hospital / provider”?
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52  ·  5. Priority WhatsApp Journeys

What priority should be assigned to “Check plan benefits”?
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53  ·  5. Priority WhatsApp Journeys

What priority should be assigned to “Check eligibility”?
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54  ·  5. Priority WhatsApp Journeys

What priority should be assigned to “Request authorisation”?
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55  ·  5. Priority WhatsApp Journeys

What priority should be assigned to “Check authorisation status”?
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56  ·  5. Priority WhatsApp Journeys

What priority should be assigned to “Claims guidance”?
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57  ·  5. Priority WhatsApp Journeys

What priority should be assigned to “Submit claim information”?
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58  ·  5. Priority WhatsApp Journeys

What priority should be assigned to “Check claim status”?
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59  ·  5. Priority WhatsApp Journeys

What priority should be assigned to “Lodge complaint”?
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60  ·  5. Priority WhatsApp Journeys

What priority should be assigned to “Check complaint / case status”?
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61  ·  5. Priority WhatsApp Journeys

What priority should be assigned to “Renew plan”?
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62  ·  5. Priority WhatsApp Journeys

What priority should be assigned to “Update member information”?
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63  ·  5. Priority WhatsApp Journeys

What priority should be assigned to “Corporate plan enquiry”?
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64  ·  5. Priority WhatsApp Journeys

What priority should be assigned to “Provider enquiry”?
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65  ·  5. Priority WhatsApp Journeys

What priority should be assigned to “Speak with customer service”?
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66  ·  5. Priority WhatsApp Journeys

Which five journeys should receive the highest priority?*

List them in priority order.

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07

Section 7

6. Health Plan Discovery & Sales

Understand products, pricing, digital sales and lead qualification.

67  ·  6. Health Plan Discovery & Sales

How many health plans / products are currently offered?
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68  ·  6. Health Plan Discovery & Sales

Which customer segments do these plans cover?
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69  ·  6. Health Plan Discovery & Sales

How are plan prices determined?
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70  ·  6. Health Plan Discovery & Sales

What factors affect pricing?
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71  ·  6. Health Plan Discovery & Sales

Can an individual currently purchase a plan without speaking with a Bastion representative?
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72  ·  6. Health Plan Discovery & Sales

Should WhatsApp help a prospective member identify an appropriate plan based on their needs?
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73  ·  6. Health Plan Discovery & Sales

Should an interested prospect automatically become a lead within CRM?
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74  ·  6. Health Plan Discovery & Sales

Should the system automatically assign qualified prospects to sales representatives?
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75  ·  6. Health Plan Discovery & Sales

What information must be captured before a sales opportunity can be considered qualified?
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08

Section 8

7. Enrolment & Member Creation

Define enrolment data, approvals and member-platform capabilities.

76  ·  7. Enrolment & Member Creation

Which platform currently manages members / enrollees?
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77  ·  7. Enrolment & Member Creation

How are new member records currently created?
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78  ·  7. Enrolment & Member Creation

What information is required for individual enrolment?
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79  ·  7. Enrolment & Member Creation

What information is required for dependant enrolment?
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80  ·  7. Enrolment & Member Creation

Are documents or photographs required?
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81  ·  7. Enrolment & Member Creation

If documents or photographs are required, please specify them.
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82  ·  7. Enrolment & Member Creation

Does enrolment require internal validation / approval before activation?
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83  ·  7. Enrolment & Member Creation

Please describe the validation / approval process.
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84  ·  7. Enrolment & Member Creation

Can the member management platform create a new member through an API?
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85  ·  7. Enrolment & Member Creation

What can the member platform return?
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09

Section 9

8. Payment Gateway & Premium Collection

Map payment methods, APIs, notifications and reconciliation.

86  ·  8. Payment Gateway & Premium Collection

Which payment gateway(s) does Bastion currently use?
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87  ·  8. Payment Gateway & Premium Collection

Which payment methods are supported?
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88  ·  8. Payment Gateway & Premium Collection

Which WhatsApp payment journeys should be considered?
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89  ·  8. Payment Gateway & Premium Collection

Does the payment gateway provide an API?
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90  ·  8. Payment Gateway & Premium Collection

Does it support webhooks / real-time payment notifications?
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91  ·  8. Payment Gateway & Premium Collection

What should happen after successful payment?

For example: payment confirmed, CRM updated, enrolment created, membership activated and welcome message sent.

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92  ·  8. Payment Gateway & Premium Collection

How are premiums currently reconciled against member records?
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10

Section 10

9. Member Identification & Authentication

Define recognition, verification and protected journeys.

93  ·  9. Member Identification & Authentication

Should an existing member be recognised automatically when contacting Bastion?
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94  ·  9. Member Identification & Authentication

How should an existing member be identified?
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95  ·  9. Member Identification & Authentication

Is the member's registered mobile number reliably stored in the current member database?
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96  ·  9. Member Identification & Authentication

Should additional authentication be required before returning member-specific information?
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97  ·  9. Member Identification & Authentication

Which authentication mechanisms are available?
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98  ·  9. Member Identification & Authentication

Which journeys should require additional authentication?
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11

Section 11

10. Provider & Hospital Directory

Understand provider data and member search requirements.

99  ·  10. Provider & Hospital Directory

Where is the provider / hospital network currently maintained?
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100  ·  10. Provider & Hospital Directory

What information is available for each provider?
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101  ·  10. Provider & Hospital Directory

Should a member be able to ask “Which hospitals near me accept my plan?”
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102  ·  10. Provider & Hospital Directory

What should provider search consider?
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103  ·  10. Provider & Hospital Directory

Is the provider directory available through an API?
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12

Section 12

11. Benefits & Eligibility

Define benefit data, safe access and agent-only enquiries.

104  ·  11. Benefits & Eligibility

Should members be able to check plan benefits through WhatsApp?
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105  ·  11. Benefits & Eligibility

Where are member benefits / eligibility currently held?
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106  ·  11. Benefits & Eligibility

Can the system return member-specific benefit information through an API?
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107  ·  11. Benefits & Eligibility

What benefit information could safely be made available through WhatsApp?
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108  ·  11. Benefits & Eligibility

Are there benefit enquiries that must always be handled by an agent?
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13

Section 13

12. Authorisation / Pre-Authorisation

Map requests, status updates, clinical review and safe disclosure.

109  ·  12. Authorisation / Pre-Authorisation

How do members / providers currently request authorisation?
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110  ·  12. Authorisation / Pre-Authorisation

What should WhatsApp support for authorisation?
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111  ·  12. Authorisation / Pre-Authorisation

Which system currently manages authorisations?
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112  ·  12. Authorisation / Pre-Authorisation

Does the authorisation system expose APIs?
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113  ·  12. Authorisation / Pre-Authorisation

Does the authorisation process require clinical or manual review?
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114  ·  12. Authorisation / Pre-Authorisation

What information is required to initiate an authorisation?
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115  ·  12. Authorisation / Pre-Authorisation

What information can safely be returned to members through WhatsApp?
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14

Section 14

13. Claims

Map submission channels, system integration and safe status information.

116  ·  13. Claims

How are claims currently submitted?
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117  ·  13. Claims

What should WhatsApp support for claims?
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118  ·  13. Claims

Which system currently manages claims?
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119  ·  13. Claims

Does the claims system expose APIs?
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120  ·  13. Claims

What claim information can be safely returned through WhatsApp?
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15

Section 15

14. Complaints, Cases & Service Requests

Define ticket creation and customer status communication.

121  ·  14. Complaints, Cases & Service Requests

How are complaints currently logged?
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122  ·  14. Complaints, Cases & Service Requests

Should WhatsApp automatically create a case / ticket for defined enquiry types?
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123  ·  14. Complaints, Cases & Service Requests

Which enquiries should create formal tickets?
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124  ·  14. Complaints, Cases & Service Requests

What should customers receive?
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16

Section 16

15. CRM & Lead Management

Define lead, member and conversation records.

125  ·  15. CRM & Lead Management

Does Bastion currently use a CRM?
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126  ·  15. CRM & Lead Management

What CRM platform is used, if applicable?
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127  ·  15. CRM & Lead Management

What should happen when a prospective member contacts Bastion?
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128  ·  15. CRM & Lead Management

What should happen when an existing member contacts Bastion?
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129  ·  15. CRM & Lead Management

Should WhatsApp conversations be retained against the customer / member record?
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130  ·  15. CRM & Lead Management

What should the CRM single view include?
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17

Section 17

16. Customer Service & Human Handover

Define teams, routing, availability and service levels.

131  ·  16. Customer Service & Human Handover

Which teams may need to receive conversations?
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132  ·  16. Customer Service & Human Handover

Approximately how many agents / users would require access?
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133  ·  16. Customer Service & Human Handover

What are the current service operating hours?
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134  ·  16. Customer Service & Human Handover

What should enquiries automatically route based on?
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135  ·  16. Customer Service & Human Handover

What should happen when automation cannot resolve an enquiry?
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136  ·  16. Customer Service & Human Handover

What should happen when no agent is available?
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137  ·  16. Customer Service & Human Handover

Are response and resolution SLAs currently defined?
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138  ·  16. Customer Service & Human Handover

If SLAs are defined, please provide details.
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18

Section 18

17. Proactive Member Communications

Identify outbound journeys, volumes and consent.

139  ·  17. Proactive Member Communications

Which outbound journeys should be considered?
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140  ·  17. Proactive Member Communications

Approximately how many outbound messages may be sent each month?
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141  ·  17. Proactive Member Communications

How is member consent for communications currently captured?
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19

Section 19

18. Omnichannel Requirements

Clarify channels and the desired agent workspace.

142  ·  18. Omnichannel Requirements

Beyond WhatsApp, which channels should the proposed service environment include?
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143  ·  18. Omnichannel Requirements

Should agents have a consolidated view of conversations across these channels?
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144  ·  18. Omnichannel Requirements

Are any existing customer service / contact centre platforms expected to remain?
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20

Section 20

19. Knowledge Base & Content

Locate approved content and its governance owners.

145  ·  19. Knowledge Base & Content

Does Bastion currently maintain a central knowledge base?
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146  ·  19. Knowledge Base & Content

Where are approved customer-service answers currently maintained?
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147  ·  19. Knowledge Base & Content

Which content is already available?
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148  ·  19. Knowledge Base & Content

Who approves member-facing content?
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21

Section 21

20. AI & Intelligent Automation

Explore useful AI capabilities and the required safeguards.

149  ·  20. AI & Intelligent Automation

Does Bastion currently use AI within any customer, operational or clinical-adjacent process?
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150  ·  20. AI & Intelligent Automation

If AI is currently used, please describe it.
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151  ·  20. AI & Intelligent Automation

Should the proposed solution explore AI-assisted customer engagement?
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152  ·  20. AI & Intelligent Automation

Which AI capabilities are of interest?
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153  ·  20. AI & Intelligent Automation

How should AI participate in customer engagement?
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154  ·  20. AI & Intelligent Automation

Where should AI not be allowed to provide an autonomous response?

Consider clinical advice, claims or authorisation decisions, and complaints requiring judgement.

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155  ·  20. AI & Intelligent Automation

Should all AI-generated customer responses be grounded only in Bastion-approved knowledge / content?
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156  ·  20. AI & Intelligent Automation

Would Bastion require human approval for certain AI-generated responses?
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157  ·  20. AI & Intelligent Automation

Are there specific AI governance, explainability or audit requirements?
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22

Section 22

21. Technology Landscape

Document current systems and integration readiness.

158  ·  21. Technology Landscape

Describe the current system, vendor, API availability and integration requirement for each capability.

Cover CRM, member administration, enrolment, claims, authorisation, provider management, payment, finance/ERP, website, member portal, mobile app, contact centre, email, SMS, identity/authentication, analytics/BI, document management and other relevant systems.

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159  ·  21. Technology Landscape

Are API specifications available for the systems above?
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160  ·  21. Technology Landscape

Are there any systems that cannot currently integrate with third-party applications?
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161  ·  21. Technology Landscape

Are legacy systems or manual databases / spreadsheets involved in any workflows?
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162  ·  21. Technology Landscape

If legacy systems or manual data sources are involved, please describe them.
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23

Section 23

22. Data, Security & Privacy

Define data categories, restrictions and assurance requirements.

163  ·  22. Data, Security & Privacy

What types of information could pass through the proposed solution?
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164  ·  22. Data, Security & Privacy

Are there categories of data that must not be stored within WhatsApp / Zoho?
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165  ·  22. Data, Security & Privacy

Which data and privacy requirements apply?
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166  ·  22. Data, Security & Privacy

Which information-security standards or internal policies must the solution comply with?
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167  ·  22. Data, Security & Privacy

Is security review / penetration testing required before go-live?
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24

Section 24

23. Reporting & Analytics

Define management measures, audiences and cadence.

168  ·  23. Reporting & Analytics

What should management be able to measure?
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169  ·  23. Reporting & Analytics

Who requires access to reporting?
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170  ·  23. Reporting & Analytics

What reporting cadence is required?
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25

Section 25

24. Service Volumes & Scalability

Size current demand and future growth.

171  ·  24. Service Volumes & Scalability

How many active members does Bastion currently support?
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172  ·  24. Service Volumes & Scalability

What growth is expected over the next 12–24 months?
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173  ·  24. Service Volumes & Scalability

Are there known periods of unusually high enquiry volume?

Consider renewals, corporate enrolment periods, campaigns and service incidents.

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174  ·  24. Service Volumes & Scalability

Should the solution support additional brands / business units in future?
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26

Section 26

25. Operating Model & Governance

Identify ownership, approval and support responsibilities.

175  ·  25. Operating Model & Governance

Who will own the solution internally?
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176  ·  25. Operating Model & Governance

Which teams need to participate in implementation?
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177  ·  25. Operating Model & Governance

Who will approve customer journeys, chatbot content, technical integrations, security/data requirements and go-live?
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178  ·  25. Operating Model & Governance

Is a formal change-management or staff adoption programme required?
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179  ·  25. Operating Model & Governance

Will agent / admin training be required?
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180  ·  25. Operating Model & Governance

Will Bastion require ongoing post-launch support and optimisation?
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27

Section 27

26. Implementation Priorities & Constraints

Clarify timing, scope, budget and dependencies.

181  ·  26. Implementation Priorities & Constraints

Is there a target go-live date?
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182  ·  26. Implementation Priorities & Constraints

Is the implementation linked to any of the following?
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183  ·  26. Implementation Priorities & Constraints

Are budget parameters already defined?
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184  ·  26. Implementation Priorities & Constraints

What implementation approach is Bastion expecting?
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185  ·  26. Implementation Priorities & Constraints

Are there known technical, operational or procurement constraints?
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28

Section 28

27. Documentation Required for Technical Discovery

Identify materials available for the next stage.

186  ·  27. Documentation Required for Technical Discovery

Which documents can Bastion provide?
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29

Section 29

28. Final Discovery Questions

Surface the highest-value opportunities and anything not yet covered.

187  ·  28. Final Discovery Questions

If Bastion could remove three points of friction from the current member experience, what would they be?*

List them in priority order.

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188  ·  28. Final Discovery Questions

Which current customer interaction consumes the most internal time or effort?
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189  ·  28. Final Discovery Questions

Which customer journey represents the greatest commercial opportunity if digitised?
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190  ·  28. Final Discovery Questions

Which journey would create the greatest improvement in member experience if automated?
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191  ·  28. Final Discovery Questions

Are there capabilities Bastion would like the future solution to enable that have not been covered in this Discovery Pulse?
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