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Mar, 2013
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Effective consumer assistance will be key to the successful implementation of the Affordable Care Act.  With open enrollment slated to begin just 7 months from now, many states are setting up their call centers to help consumers with the always daunting task of applying for health insurance programs, including Exchange and Medicaid coverage. Callers may be transferred to another entity, such as a state or county agency, to make a full Medicaid eligibility determination. Handoffs between agencies can result in a frustrating consumer experience. Clear performance guidelines are essential to optimize the possibility of a smooth, satisfactory experience.
NHeLP's California office recently teamed up with Consumers Union, the Children’s Partnership, and the Pan-Ethnic Health Network to develop principles and performance standards for Exchange Call Centers.   The principles and standards were developed to ensure those who telephone Exchange Call Centers, whether at the Federally Facilitated Exchanges (FFEs)  or at state-run Exchanges, have a consumer friendly, successful experience applying for coverage over the telephone. 
The Customer Service Principles and Performance Standards for Exchange Call Center include:

  • Answering call quickly
  • Keeping hold times to a minimum
  • Limiting use of automation and voice mail
  • Asking consumers to provide information only once
  • Allowing real time eligibility in most cases with one call
  • Implementing performance standards and monitoring 

To access the Customer Service Principles and Performance Standards, Click Here