Maryland Health Connection’s Consolidated Service Center
How it’s Powered Provided by Maximus Health Services Oracle ‘Right Now’ Customer Relationship Management (CRM) –Database –Knowledgebase –Workflow Management Interactive Intelligence Customer Interaction Center (CIC) –IVR/Call flow/ACD Call Distribution –Workforce Management (WFM) –Quality Monitoring Overview - Consolidated Service Center 2
Call Center Structure 125 Staff English/Spanish CSR Support Command Center – Forecasting, WFM, Service Levels Resource Center – Leads/Escalation Supervisors/Manager/Director Quality Assurance/Trainers Customer Service Representatives (CSRs) Overview - Consolidated Service Center 3
Call Center Issued ‘Permits’ –Eligibility Determinations –Enrollment in Quality Health Programs Medicaid and MCHIP Support Eligibility Appeals – Informal Resolution Help Desk – Tier 1 Support for Consumer/Internal MHC Users Billing and Payment Services –Initial Premium Billing for Consumers –Ongoing SHOP Billing Language Line (200) CSC Services 4
Inbound/Outbound Mail General Mail Correspondence Appeals Process Paper Applications MHC Generated Notices Requests for Paper Applications Voter Registration Cards Fulfillment Center 5 CSC Services
Questions/Requests Specific to Carriers –Plan specific inquiries once enrolled Questions or required support from other agencies –Immediate Medicaid –Medicare Maryland –Various health and human services needs Warm Transfers –‘No Wrong Door’ Reasons/Method 6 Hand-Offs to Assist
Main (MHC)-8572 TTY (MHC)-8573 FAX – (MHC)-8574 Contact Information 7 CSC Phone Numbers
Open Enrollment (October 1, 2013 – March 31, 2014) –Monday – Friday, 8:00 am – 8:00 pm –Saturday, 8:00 am – 6:00 pm –Sunday, 8:00 am – 2:00 Non-Open Enrollment –Monday – Friday, 8:00 am – 6:00 pm –Saturday, 8:00 am – 12:00 pm –Sunday, Closed 8 CSC Business Hours
MHC Contact - CSC Operations Lee Ann Sapp Manager, Consolidated Service Center Questions 9