working productively with the marketplace call center
TRANSCRIPT
© 2016 Enroll America | StateOfEnrollment.org
Tracy Zander, MPH, Navigator, Family and Children’s Service | 05.13.2016
Working Productively with the Marketplace Call Center: An Emphasis on Immigrant Populations
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Objectives:
• To enhance productivity and experiences with the Marketplace call center
• To discuss and share other solutions and advice from other assisters
• To uncover solutions while working with the Marketplace call center with more challenging immigrant cases
© 2016 Enroll America | StateOfEnrollment.org
• Increasingly challenging cases• Less buy-in from consumers• More time spent with consumers who aren’t eligible due
to coverage gap• More time needed for outreach to find uninsured
consumers
Why Enhance Productivity?
© 2016 Enroll America | StateOfEnrollment.org
• To demonstrate to consumers that they can count on us• To ensure the enrollment process is positive• To help the consumer learn how they can navigate the
system• For the consumer to be empowered and proactive • To avoid filing an appeal• To make our jobs easier and more positive
Why enhance the experience?
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…..Seriously!!
Take out your phone!
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© 2016 Enroll America | StateOfEnrollment.org
© 2016 Enroll America | StateOfEnrollment.org 8
Top 10 states: Call Center Volume
INFORMATION NOT RELEASEABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW: This information has not been publically disclosed and may be privileged and confidential, It is for internal government use only and must not be disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosure may result in the prosecution to the full extent of the law.
© 2016 Enroll America | StateOfEnrollment.org
© 2016 Enroll America | StateOfEnrollment.org 10
Background
• Tennessee uses the Health Insurance Marketplace as the only application portal to apply for Medicaid and CHIP
• There is no specific Medicaid or CHIP application
• State offices stopped offering Medicaid assistance December, 2013
• “You can also go to your local Medicaid office” Not an option.
© 2016 Enroll America | StateOfEnrollment.org
© 2016 Enroll America | StateOfEnrollment.org
© 2016 Enroll America | StateOfEnrollment.org
• In 2012 Nashville had the fastest-growing immigrant population of any American city
• One out of every five Nashville students is Latino• Over 140 languages are spoken through city schools• New international arrivals are responsible for 60 percent of the
city’s population growth in the past decade
Background
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Background
• Nearly 90% of patients are foreign-born coming from more than 80 countries and speaking more than 70 languages
• 5,000 patient visits per year translating into 21,000 patient encounters
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Top 10 Languages Requested at Call Center
• In total, the call center received 45,067 calls for languages other than English and Spanish during OEP Year 3
• The top 4 languages represent over 50% of all requests to the Language Line
n= 8,564
n= 7,326
n= 3
,495
n= 3,
414
INFORMATION NOT RELEASEABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW: This information has not been publically disclosed and may be privileged and confidential, It is for internal government use only and must not be disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosure may result in the prosecution to the full extent of the law.
Spanish n= 919,045English n= 13,302,655
© 2016 Enroll America | StateOfEnrollment.org
© 2016 Enroll America | StateOfEnrollment.org
© 2016 Enroll America | StateOfEnrollment.org
What is the best way to address inconsistencies?
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PREVENT THEM!
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London, Kentucky
In our experience…
• (701) area code number does not go through
• Bottom line: if possible, upload to account online because it is updated in real time
• Ask for more time
© 2016 Enroll America | StateOfEnrollment.org
Inconsistencies
SUBMITTED
VERIFIED
1. 2.3
.
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After you submit the required verification, inform the consumer that the Health Insurance Marketplace will still send notices of the inconsistency until it is verified. These notices cause many consumers unnecessary panic.
© 2016 Enroll America | StateOfEnrollment.org
Prevent inconsistencies
• When healthcare.gov asks for certificate of citizenship:• Go back to the beginning of the application and start again• Remove that application and start anew• Go back through application when you have the certificate
information• Optional, but an inconsistency will remain…
Alien number/USCIS
Certificate number
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Selecting documents properly
This should not be checked for undocumented individuals
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© 2016 Enroll America | StateOfEnrollment.org
Common immigration documents
Sometimes the number is written here instead
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Identity verification
Allowed
2submissions
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© 2016 Enroll America | StateOfEnrollment.org
© 2016 Enroll America | StateOfEnrollment.org
Allowed
2submissions
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Optional
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© 2016 Enroll America | StateOfEnrollment.org
© 2016 Enroll America | StateOfEnrollment.org
The application ID is created early on during the application. Have it easily accessible if you need to call the Marketplace and offer to reference it first with the state you are calling from.
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Then STOP. Do not press “Save and continue.”
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Read and explain the agreement statements to the consumer before calling the Marketplace to avoid confusion and to keep consumer prepared and informed
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If you see this screen, you’ve gone too far…
© 2016 Enroll America | StateOfEnrollment.org
© 2016 Enroll America | StateOfEnrollment.org
• Call volume increased by 7.6% from November 15th to December 31st and decreased by 7.2% in the last 30 days of Open Enrollment.
• Shift is likely due to increased number of consumers renewing coverage and can be expected to continue
• Customer Satisfaction increased – OE2 vs OE3 73% to 78%• Strong focus on soft skills in CCR training and quality
Consumer Call Patterns
INFORMATION NOT RELEASEABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW: This information has not been publically disclosed and may be privileged and confidential, It is for internal government use only and must not be disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosure may result in the prosecution to the full extent of the law.
© 2016 Enroll America | StateOfEnrollment.org
Marketplace Call Center Volume
INFORMATION NOT RELEASEABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW: This information has not been publically disclosed and may be privileged and confidential, It is for internal government use only and must not be disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosure may result in the prosecution to the full extent of the law.
© 2016 Enroll America | StateOfEnrollment.org
Call Arrival Pattern
INFORMATION NOT RELEASEABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW: This information has not been publically disclosed and may be privileged and confidential, It is for internal government use only and must not be disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosure may result in the prosecution to the full extent of the law.
© 2016 Enroll America | StateOfEnrollment.org
• • For 60 of 92 days of Open
Enrollment, there is less than a 5 minute daily average speed of answer.
• On 28 or 92 days, speed of answer was under 30 seconds.
Customer Wait Times
INFORMATION NOT RELEASEABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW: This information has not been publically disclosed and may be privileged and confidential, It is for internal government use only and must not be disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosure may result in the prosecution to the full extent of the law.
© 2016 Enroll America | StateOfEnrollment.org
Marketplace Call Center Volume
Spanish n= 919,045English n= 13,302,655
INFORMATION NOT RELEASEABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW: This information has not been publically disclosed and may be privileged and confidential, It is for internal government use only and must not be disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosure may result in the prosecution to the full extent of the law.
© 2016 Enroll America | StateOfEnrollment.org
Call Center Topics
Plan Compare and Enrollment Closing Language:
Creating and Managing Your Healthcare.gov Account
Online Application Lead-In
Marketplace Plan Re-Enrollment/BAR
Ending Marketplace Coverage
Marketplace Call Center Information
How/Where do I send my docs
Lowering Costs on Monthly Premiums
Resolving Data Matching
Reporting a Life Change
Call Topics
OEP3 OEP2
INFORMATION NOT RELEASEABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW: This information has not been publically disclosed and may be privileged and confidential, It is for internal government use only and must not be disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosure may result in the prosecution to the full extent of the law.
© 2016 Enroll America | StateOfEnrollment.org
Common Marketplace Referrals
Top 10 Referrals1. Medicaid 162,695
2. 1-800 Medicare 18,620
3. IRS 13,519
4. CHIP 11,259
5. Certified App Counselor 11,238
6. State Dept of Insurance 8,109
7. HRSA 6,541
8. Agent / Broker 5,885
9. Navigator 5,188
10. SHOP Call Center 3,365
INFORMATION NOT RELEASEABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW: This information has not been publically disclosed and may be privileged and confidential, It is for internal government use only and must not be disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosure may result in the prosecution to the full extent of the law.
© 2016 Enroll America | StateOfEnrollment.org
Leaving the Medicaid GAP SEP
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• Can only be accessed by contacting the marketplace call center
• Call center representatives can no longer automatically grant this SEP
Receive eligibilit
y for APTC
Call the call center to request SEP to enroll in
coverage
Representative will forward
application for review
10 business
day processin
g time
Receive mail
confirming SEP
granted
Enroll online or via the
call center!
Leaving the Medicaid GAP SEP
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*Online option to file an appeal coming December, 2016!!!
* Wait about3-11 months
A note about appeals…
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• Wrong eligibility determination? Why?• Try to avoid/prevent them• 90 days or ‘as administratively feasible as possible’• Expedited appeals• Separate entity: not associated with Marketplace call center nor
London, KY
Appeals continued
© 2016 Enroll America | StateOfEnrollment.org
Even with sophisticated design, user experience
is what matters
© 2016 Enroll America | StateOfEnrollment.org
• What have you found helpful that we haven’t yet mentioned?
Your experience
© 2016 Enroll America | StateOfEnrollment.org
• What constructive feedback do you have for the Marketplace Call Center?
Your feedback
© 2016 Enroll America | StateOfEnrollment.org
© 2016 Enroll America | StateOfEnrollment.org
Moving away from…
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…to this!
© 2016 Enroll America | StateOfEnrollment.org
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(Just Kidding!!!)