Highly experienced agents use member information to contact select beneficiaries to educate, encourage, and assist with referrals and appointments, making scheduling easy by conferencing members and providers directly. We can even help coordinate benefits-covered transportation.
Outreach programs include:
First impressions can have lasting effects. That’s why we make sure your new member experience starts with a warm welcome from our friendly and knowledgeable agents. Members are provided an opportunity to discuss benefits and to learn how to access them even before plan information is received, covers any available PCP information, and more. We can even look up formularies and share details on fitness programs and other benefits that are often overlooked by members.
Knowledge is power. It’s an old adage, but understanding why a member enrolled or dis-enrolled, what benefits are least and most desirable or how satisfied various segments are with your plan can provide a solid road map for strategic action. Our experienced teams will help design and skillfully administer your survey for maximum results, including HEDIS and HOS phone calls and letters.
Health Risk Assessments
Non-clinical HRAs are a key part of any prevention or wellness health plan. Through a fully integrated approach, our contact center agents can review a member’s call history and ask questions to assess risk factors for common conditions and chronic diseases. They’ll also collect patient assessment information (PAFS) and address any current issues, ensuring that those points receive follow-up action in pre-defined turn-around times.
Annual Notice of Change
Compassionate, well-orchestrated member experience and reliable member attrition analysis are paramount to retaining beneficiaries after delivering a notification of changes to their healthcare plan. That’s why our thoughtfully developed, full-service telephonic campaigns begin with pre-call work administered by agents specially trained to examine call history, demographics, disease state, subsidy level and factors including effective dates, benefits, plan name, region and more.
Armed with this detail and strategic talking points as their guide, they engage beneficiaries in productive, intelligent and customer-centric conversations to confirm receipt of ANOC packets, ensure complete comprehension of the enclosed letter and benefits changes and gauge the likelihood they will remain in your plan. Their carefully documented feedback will pinpoint attrition risks so you can quickly deploy additional outreach or touch points to achieve maximum retention rates.
Click below to learn more about Member Experience Member Outreach (MEMO), our suite of outreach services designed to improve the health and happiness of members.