| Boon-Chapman
strives for excellence in customer service. Every new employee
attends a customer service training session and calls are continuously
monitored for responsiveness, politeness and accuracy of information
provided. This provides for continuous quality improvement.
Additionally, we are committed to serving our Spanish-speaking
plan participants and health care providers.
We handle customer service with a team approach. Each team
includes an account manager, a team leader, several claim
analysts, and one or more customer service representatives.
Each team is a unit in the claims area. Team members are cross-trained,
so they can assist other team members. Working in the same
unit on a limited number of clients promotes team members
taking pride in providing the best service to their clients.
One or more designated claim analysts will have primary responsibility
for the carrier or client's claims. However, all others within
the team are also familiar with the account to provide uninterrupted
personal service whenever the designated analyst or customer
service representative is unavailable. Participants can reach
their customer service representative by phone by entering
their group number. If the designated person is unavailable,
the call will rotate to another member of the team.
Boon-Chapman maintains a toll-free telephone line for the
convenience of plan participants and providers. An automated
answering system allows for prompt initial response and caller
selection of the department needed. Our performance standards
require we maintain an average telephone response time of
30 seconds.
Our automated response system, which has a real-time interface
with the claims system, allows a health care provider with
either a touch-tone phone and fax machine or a web browser
and internet access, to instantly determine eligibility, benefits
and claims status 24 hours a day 365 days a year. The system
was selected because it assures consistent and accurate information
is provided and reduces the time a customer service representative
will spend on routine phone calls. Further, its speed and
ease of use promotes excellent provider relations.
Further, the system allows a plan participant to check claim
status 24 hours a day 365 days a year through an automated
voice response. Plan participants with access to a web browser
can download forms, view their plan coverage and submit claim
questions. Of course, callers may also choose to speak to
a customer service representative during business hours. |
