Member Services a. Instructions on how to contact the Member Services Call Center and a description of the functions of Member Services;
Member Services. The HMO must maintain a Member Services Department to assist Members and Members’ family members or guardians in obtaining Covered Services for Members. The HMO must maintain employment standards and requirements (e.g., education, training, and experience) for Member Services Department staff and provide a sufficient number of staff for the Member Services Department to meet the requirements of this Section, including Member Hotline response times, and Linguistic Access capabilities, see 8.1.5.6
Member Services. The Manager shall (i) manage and coordinate distributions and payments to Members; (ii) manage and coordinate communications with Members; (iii) distribute reports, updates, and other information to Members; (iv) handle redemption requests from Members; and (v) provide services in the nature of investor relations.
Member Services. The MCO must maintain a Member Services Department to assist Members and their family members or guardians in obtaining Covered Services for Members. The MCO must maintain employment standards and requirements (e.g., education, training, and experience) for Member Services Department staff and provide a sufficient number of staff for the Member Services Department to meet the requirements of this Section.
Member Services. The Manager shall:
Member Services. Supplier will consult with each Member to identify the Member's policies relating to access to facilities and personnel. Supplier will comply with such policies and will establish a specific timetable for sales calls by sales representatives to satisfy the needs of the Member. Supplier will promptly respond to Members' reasonable requests for verification of purchase history. If requested by Novation or any Members, Supplier will provide, at Supplier's cost, on-site inservice training to Members' personnel for pertinent Products.
Member Services. As used in this Agreement, the package of health care and related services described in Member Services / Membership Fee (Appendix A), which is attached to this Agreement, and incorporated by reference.
Member Services. The Contractor must submit reports related to Member Services in accordance with Section 11, Reporting Requirements, and Exhibit H, Reporting Requirements, of this Contract.
Member Services. 4.1 Marketing and Outreach Marketing efforts shall be targeted to the general community in the State of Indiana. In accordance with 42 CFR 438.104, and the requirements outlined in Section 4.5, the Contractor must obtain State approval for all marketing materials at least thirty (30) calendar days prior to distribution. All marketing materials must be distributed to the Contractor’s entire service area and shall comply with the information requirements delineated at 42 CFR 438.104 and should include the requirements and benefits of the Contractor’s health plans, as well as the Contractor’s provider network. Such materials shall be in a manner and format that is easily understood and meet the general communication material requirements discussed in this Section 4. Marketing materials should include the requirements and benefits of the Contractor’s health plan, as well as the Contractor’s provider network. The Contractor may market via digital, mail, and mass media advertising (e.g., radio, television and billboards). Community oriented marketing such as participation in community health fairs is encouraged. The Contractor may offer to potential members tokens or gifts of nominal value, as long as the Contractor acts in compliance with all marketing provisions provided for in 42 CFR 438.104, which addresses marketing activities, and other federal and state regulations and guidance regarding inducements in the Medicare and Medicaid programs. The Contractor shall conduct marketing and advertising in a geographically balanced manner, paying special attention to rural areas of the State. The Contractor shall provide information to potential eligible individuals who live in medically underserved rural areas of the State. Any outreach and marketing activities (written and oral) shall be presented and conducted in an easily understood manner and format, at a fifth-grade reading level. The Contractor may not seek to influence enrollment in conjunction with the sale or offering of any private insurance and may not directly, or indirectly engage in door-to-door, telephone, email, texting, or other cold-call marketing activities. Cold-call marketing is defined at 42 CFR 438.104 and includes any unsolicited personal contact by the Contractor with a potential Medicaid member. The Contractor shall ensure marketing materials are accurate and do not mislead, confuse or defraud members or the State. Statements considered inaccurate, false, or misleading include, but are not ...
Member Services. 4.1 Marketing and Outreach
