Please click on the case study you would like to view.
>>MEDFONE
Helps HMO Provide Insurance To Over 200,000
Economically Underprivileged Members
A major state-wide managed care organization was sought
to establish a variety of free or low cost health
insurance plans for families with limited incomes. Based
on the nature of their program, they were approved and
overseen by the New York State Department of Health.
This organization needed a call center to recruit and
help retain members. Their mission is to make sure that
every man, woman and child-regardless of age, race, sex,
religion, citizenship or ethnic background – has
access to quality healthcare. They needed a call center
to process after hour calls from members who needed
assistance reaching their primary care physician and to
provide member support as well as provider support. As
their program grew, they also required lead generation
and lead qualification services.
After extensive consultation with this client MEDFONE
developed an after hour service program that has become
a Help Desk for member and provider inquiries. This
includes, but is not limited to, assisting callers in
reaching their primary care physician; verifying
eligibility by managing their database; providing
information regarding pharmacy and dental benefits;
arranging transportation services; and processing calls
for behavioral health issues.
Concurrently, MEDFONE developed and implemented a
24/7/365 inbound lead generation and qualification
program to support their aggressive, State-wide
marketing campaign. MEDFONE documents caller
information and, on a daily basis, distributes leads to
the appropriate regional marketing team located within
the State.
MEDFONE has helped this organization meet and
maintain its strict regulatory requirements for 24 hour
coverage. MEDFONE has also enhanced the
organization’s member and provider relations and has
helped the company enroll over 200,000 members – more
than doubling its membership. MEDFONE’s
solutions are continuing to help this organization
realize its mission.
|
