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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 2-1-1– Various health and human services needs
Warm Transfers– ‘No Wrong Door’
Reasons/Method
6
Hand-Offs to Assist
Main - 855-642(MHC)-8572
TTY - 855-642(MHC)-8573
FAX – 855-642(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
410-547-8150
Questions
9
