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Maryland Health Connection’s Consolidated Service Center

Maryland Health Connection’s Consolidated Service Center. Overview - Consolidated Service Center. How it’s Powered Provided by Maximus Health Services Oracle ‘Right Now’ Customer Relationship Management (CRM) Database Knowledgebase Workflow Management

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Maryland Health Connection’s Consolidated Service Center

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  1. Maryland Health Connection’s Consolidated Service Center

  2. Overview - 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

  3. Overview - Consolidated Service Center 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)

  4. CSC Services 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)

  5. CSC Services Fulfillment Center • Inbound/Outbound Mail • General Mail Correspondence • Appeals Process • Paper Applications • MHC Generated Notices • Requests for Paper Applications • Voter Registration Cards

  6. Hand-Offs to Assist Reasons/Method • Questions/Requests Specific to Carriers • Plan specific inquiries once enrolled • Questions or required support from other agencies • Immediate Medicaid • Medicare • Maryland 2-1-1 • Various health and human services needs • Warm Transfers • ‘No Wrong Door’

  7. CSC Phone Numbers Contact Information • Main - 855-642(MHC)-8572 • TTY - 855-642(MHC)-8573 • FAX – 855-642(MHC)-8574

  8. CSC Business Hours • 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

  9. Questions MHC Contact - CSC Operations Lee Ann Sapp Manager, Consolidated Service Center leeann.sapp@maryland.gov 410-547-8150

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