Member Services Helpline Sample Clauses

Member Services Helpline. The Contractor shall maintain a statewide toll-free telephone helpline staffed with trained personnel knowledgeable about the Hoosier Healthwise program equipped to handle a variety of member inquiries, including the ability to address member questions, concerns, complaints and requests for PMP changes. The same helpline shall be available to Hoosier Healthwise members, so that members may call one number to answer all the family’s questions.
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Member Services Helpline. The Contractor shall maintain a statewide toll-free telephone helpline staffed with trained personnel knowledgeable about the HIP program equipped to handle a variety of member inquiries, including the ability to address member questions, concerns, complaints and requests for PMP changes. The same helpline shall be available to HIP members, so that members may call one number to answer all the family’s questions. Member helpline staff shall be equipped to provide customer service to individuals assigned to the Contractor’s plan who have not yet made their first POWER Account contribution. The Contractor shall staff the member services helpline to provide sufficient “live voice” EXHIBIT 2.I
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Member Services Helpline. The Contractor shall maintain a statewide toll-free telephone helpline staffed with trained personnel knowledgeable about the HIP program equipped to handle a variety of member inquiries, including the ability to address member questions, concerns, complaints and requests for PMP changes. The same helpline shall be available to HIP members, so that members may call one number to answer all the family’s questions. Member helpline staff shall be equipped to provide customer service to individuals assigned to the Contractor’s plan who have not yet made their first POWER Account contribution. Member helpline staff shall be knowledgeable about the GTW program including program explanation, member status, basic GTW questions, and referrals to resources. The Contractor shall staff the member services helpline to provide sufficient “live voice” access to its members during, at a minimum, a twelve (12)-hour business day, from 8 a.m. to 8 p.m.
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Member Services Helpline. DVHA shall continue to maintain a statewide toll-free telephone helpline staffed with trained personnel knowledgeable about the Vermont Medicaid program as well as basic information about the Contractor’s programs. DVHA’s member services helpline is intended to be equipped to handle a variety of basic, first-tier Member inquiries, including the ability to address Member questions, concerns, complaints and requests for PCP changes. Contractor shall be responsible for its own member services helpline to handle second-tier questions from Members (including issues that require specific expertise and authority by Contractor to resolve). Staff assigned to this function will be available to all Member incoming inquiries via “live voice” between 8 a.m. and 4:30 p.m. Eastern Standard Time, Monday through Friday. Contractor shall provide an after-hours voice message system that informs callers of Contractor’s business hours and offers an opportunity to leave a message after business hours. Calls received in the voice message system shall be returned within one (1) business day. During hours of operation, Contractor must be able to receive transfers from DVHA’s member services helpline, Agency of Human Services (AHS) staff and Members who wish to directly call Contractor. Contractor’s helpline may be closed on all holidays observed by the State of Vermont. Call center closures, limited staffing or early closures shall not burden a Member’s access to care. Contractor’s helpline shall offer language interpretation services for Members whose primary language is not English and shall provide teletypewriter (TTY) services for hard of hearing Members free of charge. Contractor’s Helpline staff shall be trained to ensure that Member questions and concerns are resolved as expeditiously as possible. Contractor shall maintain a system for tracking and reporting the number and type of Members’ calls and inquiries it receives during business hours and non-business hours. Contractor shall monitor its member services helpline service and report its telephone service level performance to DVHA in the timeframes and specifications described in the ACO Reporting Manual. Upon a Member’s attribution to the VMNG Program, Contractor shall inform the Member about DVHA’s member services helpline as well as Contractor’s helpline. Contractor must meet the following performance standards related to the responsiveness of staffed telephone lines:
Sample 1
Member Services Helpline. The Contractor shall maintain a statewide toll-free telephone helpline staffed with trained personnel knowledgeable about the HIP program equipped to handle a variety of member inquiries, including the ability to address member questions, concerns, complaints and requests for PMP changes. The same helpline shall be available to HIP members, so that members may call one number to answer all the family’s questions. Member helpline staff shall be equipped to provide customer service to individuals assigned to the Contractor’s plan who have not yet made their first POWER Account contribution.
Sample 1
Member Services Helpline. The MCO must maintain a statewide toll-free telephone helpline for members with questions, concerns or complaints. The MCO must staff the member services helpline to provide sufficient “live voice” access to its members during (at a minimum) a ten-hour business day, Monday through Friday. The member services helpline must offer language translation services for members whose primary language is not English and must offer telephone-automated messaging in English and Spanish. A member services messaging option must be available after business hours in English and Spanish and member services staff must respond to all member messages by the end of the next business day. The MCO must provide Telecommunications Device for the Deaf (TDD) services for hearing impaired members. The MCO must establish telephonic capability to transfer calls and connect the member to the State’s enrollment broker whenever appropriate (i.e., to facilitate the member’s changing to another PMP). The MCO must maintain a system for tracking and reporting the number and type of members’ calls and inquiries it receives during business hours and non-business hours. The MCO must monitor its member services helpline service and report its telephone service performance to OMPP each month as described in the MCO Reporting Manual. The MCO’s member services helpline staff must be prepared to respond to member concerns or issues including, but not limited to the following: • Access to health care services • Identification or explanation of covered services • Special health care needs • Procedures for submitting a member grievance or appeal • Potential fraud or abuse Upon a member’s enrollment in the MCO, the MCO must inform the member about the member services helpline. The MCO should encourage its members to call the MCO member services helpline as the first resource for answers to questions or concerns about Hoosier Healthwise, PMP issues, benefits, MCO policies, etc.
Sample 1
Member Services Helpline. The Contractor shall maintain a dedicated toll-free Member services helpline staffed with trained personnel knowledgeable about the Program. Helpline staff shall be equipped to handle a variety of Enrolled Member inquiries. The telephone line shall be staffed with live- voice coverage during normal working days (Monday through Friday), excluding State holidays, and shall be accessible, at minimum, during working hours of 7:30 a.m. - 6:00 p.m.
Sample 1
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Related to Member Services Helpline

  • REGULATORY ADMINISTRATION SERVICES BNY Mellon shall provide the following regulatory administration services for each Fund and Series:  Assist the Fund in responding to SEC examination requests by providing requested documents in the possession of BNY Mellon that are on the SEC examination request list and by making employees responsible for providing services available to regulatory authorities having jurisdiction over the performance of such services as may be required or reasonably requested by such regulatory authorities;  Assist with and/or coordinate such other filings, notices and regulatory matters and other due diligence requests or requests for proposal on such terms and conditions as BNY Mellon and the applicable Fund on behalf of itself and its Series may mutually agree upon in writing from time to time; and

  • Customer Services Customer Relationship Management (CRM): All aspects of the CRM process, including planning, scheduling, and control activities involved with service delivery. The service components facilitate agencies’ requirements for managing and coordinating customer interactions across multiple communication channels and business lines. Customer Preferences: Customizing customer preferences relative to interface requirements and information delivery mechanisms (e.g., personalization, subscriptions, alerts and notifications).

  • Stock Plan Administration Service Provider The Company transfers the Participant's Personal Information to Fidelity Stock Plan Services LLC, an independent service provider based in the United States, which assists the Company with the implementation, administration and management of the Plan (the “Stock Plan Administrator”). In the future, the Company may select a different Stock Plan Administrator and share the Participant's Personal Information with another company that serves in a similar manner. The Stock Plan Administrator will open an account for the Participant to receive and trade Shares acquired under the Plan. The Participant will be asked to agree on separate terms and data processing practices with the Stock Plan Administrator, which is a condition to the Participant’s ability to participate in the Plan. (c)

  • ADMINISTRATION SERVICES When a medical prescription drug is administered by infusion, the administration of the prescription drug may be covered separately from the prescription drug. See Infusion Therapy - Administration Services in the Summary of Medical Benefits for benefit limits and the amount you pay. Prescription drugs that are self-administered are not covered as a medical benefit but may be covered as a pharmacy benefit. Please see Pharmacy Prescription Drugs and Diabetic Equipment or Supplies – Pharmacy Benefits section above for additional information. Site of Care Program For some medical prescription drugs, after the first administration, coverage may be limited to certain locations (for example, a designated outpatient or ambulatory service facility, physician’s office, or your home), provided the location is appropriate based on your medical status. For a list of medical prescription drugs that are subject to this Site of Care Program, visit our website. Preauthorization may be required to determine medical necessity as well as appropriate site of care. If we deny your request for preauthorization, or you disagree with our determination for the appropriate site of care, you can submit a medical appeal. See Appeals in Section 5 for information on how to file a medical appeal.

  • Customer Service A. PRIMARY ACCOUNT REPRESENTATIVE. Supplier will assign an Account Representative to Sourcewell for this Contract and must provide prompt notice to Sourcewell if that person is changed. The Account Representative will be responsible for: • Maintenance and management of this Contract; • Timely response to all Sourcewell and Participating Entity inquiries; and • Business reviews to Sourcewell and Participating Entities, if applicable.

  • Stock Plan Administration Service Providers The Company transfers Data to Xxxxxx Xxxxxxx Xxxxx Xxxxxx LLC, an independent service provider, which is assisting the Company with the implementation, administration and management of the Plan. In the future, the Company may select a different service provider and share Data with such other provider serving in a similar manner. The Participant may be asked to agree on separate terms and data processing practices with the service provider, with such agreement being a condition to the ability to participate in the Plan.

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  • Services Unique It is agreed that the services to be rendered by Employee hereunder are of a special, unique, unusual, extraordinary and intellectual character which gives them a peculiar value, the loss of which cannot be reasonably or adequately compensated in damages in an action at law and that a breach by Employee of any of the provisions contained herein will cause the Company irreparable injury and damage. Employee expressly agrees that the Company shall be entitled to injunctive or other equitable relief to prevent a breach hereof. Resort to any such equitable relief shall not be construed as a waiver of any of the rights or remedies which the Company may have against Employee for damages or otherwise.

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