A step forward – improvements in claims and call center response

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We are pleased to announce that we have seen significant improvement in our provider call wait times and claims processing since the beginning of the year.

We’ve added several new customer service representatives to our existing team. All of whom have completed their training and are now answering calls. Additionally, our call-back feature – which allows you to leave a phone number for one of our representatives to call you back by the end of the day – has been well received. Our provider call wait times have significantly decreased year to date – averaging 2.5 minutes in March. And, we are working on more improvements to our customer service functionality to help ensure a better caller experience – including the ability to text or chat with our customer service team and search for patient-specific benefit information on our website through a CDT code look-up feature.

In the claims department, we continue to exceed our target of processing 90% of claims within 14 days, and 90% of the electronic claims we receive are processed and paid automatically without the need for additional review. When additional review is needed, our claims processing professionals can move the claim forward more quickly and efficiently because of enhancements made in our enterprise system upgrade that allow for fewer steps to manually review.

Thank you for your patience, support and ongoing service to our members. We will continue to explore and implement new methods to improve our customer service and claims processing to bring you industry-leading support and service.

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