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Elisa Elderbaum

Collecting, Managing, & Analyzing User Feedback. Elisa Elderbaum. IT Business Advisor National Government Services, formerly Empire Medicare Services. Agenda. Introduction - National Government Services Reports Compliance Reports Operations Reports Continuous Improvement Lessons Learned

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Elisa Elderbaum

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  1. Collecting, Managing, & Analyzing User Feedback Elisa Elderbaum IT Business Advisor National Government Services, formerly Empire Medicare Services

  2. Agenda • Introduction - National Government Services • Reports • Compliance Reports • Operations Reports • Continuous Improvement • Lessons Learned • Future Improvements 2

  3. National Government Services 3

  4. National Government Services • Serves over 22.5 million people with Medicare in 26 states • In 2006, responded to 10.4 millions calls • Processed over 208 million Medicare claims and administered benefits of more than $87.9 billion • Currently at 240 ports • Contact center locations: • Syracuse, NY • Bohemia, NY • Harrisburg, PA • Milwaukee, WI • Indianapolis, IN • Manchester, NH • Cincinnati, OH 4

  5. Medicare Insurance Programs • Part A – Medicare Hospital Insurance (Hospitals) • Part B – Medicare Supplementary Medical Insurance (Doctor’s Offices) • Part C – Medicare HMO Program • Part D – Medicare Prescription Drug Benefit 5

  6. Self-Service Options Medicare Part B • Patient Eligibility • Claims Status • Patient Deductible Status • Procedure Code Pricing • Seminar Schedules • Earnings • Commonly Requested Telephone Numbers • Commonly Requested Addresses • Fax-On-Demand Information • Appeal Rights Medicare Part A • Patient Eligibility • Claims Status • Financial Information (Check Remittance) • Commonly Requested Telephone Numbers • Commonly Requested Addresses • Commonly Requested Websites • Hours of Operation • Seminar Information • HMO Information • Appeal Rights 6

  7. Reports • Compliance Reports • Operations Reports • Continuous Improvement • Dashboard 7

  8. Compliance Reports 8

  9. Compliance Reports • The Centers for Medicare and Medicaid Services (CMS) have established Service Level Agreements that contractors must meet • National Government Services submits these weekly reports externally to CMS to remain in compliance 9

  10. Compliance Reports 10

  11. Operations Reports 11

  12. Operations Reports • Reports used internally for day-to-day maintenance of the systems • IVR Port Utilization • Application Failure Report • Host Transaction Failure Report 12

  13. IVR Port Utilization Daily IVR Port Utilization Report Period: 07/01/07 – 07/07/07 13

  14. Port Utilization Trends IVR Port Utilization 2007 YTD 14

  15. Backend Transaction Failures 15

  16. Continuous Improvement 16

  17. Continuous Improvement • Reports are generated daily, weekly and monthly for to track IVR activity • Augments automation by identifying areas for improvement critical to the success of automation • Reports are used internally to identify improvement areas • Reports are also used externally as a continuous education process 17

  18. Completed Transaction Summary 18

  19. Failed Transaction Summary 19

  20. Failed Transactions by Provider Failed Transactions by Provider X1 X5 X4 X1 X2 X3 X4 X5 X3 X2 20

  21. Lessons Learned 21

  22. Lessons Learned • Improvement is a continuous process • Empower your live agents • Teach them the automated system so they can teach your callers • Listen to your callers; factor in their wants & needs into your improvement plans • Treat automated “agents” like live agents • Train and refine the automated “agent” • Use IVR system reports to help guide the improvement process • Technology can only take you so far • Analyze the data – don’t wait until the end of the project. Understand what it means 22

  23. Future Improvement 23

  24. Future Improvement • Dashboard • Single real-time, view of entire system by application, backend, and system perspective • Trend Analysis • Analyze trends in call volume, call types, system utilization, etc • Allows for point or spot analysis 24

  25. THANK YOU! Elisa Elderbaum IT Business Advisor National Government Services 25

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