# Presentation: 665146

## Beneficiary Telephone Inquiries (1-800 MEDICARE & Fee For Service)

**SHIP Meeting****November 2007**

***Beneficiary Telephone Inquiries ******(1-800 MEDICARE & Fee For Service)***

**Office of Beneficiary Information Services**

**CMS**

## 1-800 MEDICARE Call Volume

- Approximately, 29 million calls were received at 1-800-MEDICARE during Fiscal Year 2007.
- As of October 20, 2007, there are over 3,000 CSRs at eight call centers
- The Broadriver S.C. call center was opened to support the call spike
- Lawrence, KS and Phoenix, AZ are our two 24 hours, seven days a week call centers.

## Mondays and Tuesdays are the busiest days for 1-800 MEDICARE.
10:00 a.m. – 2:00 p.m. is traditionally the busiest hours during the day.   
4:30 p.m. – 6:00 p.m. are usually the busiest hours for Claims 
The budgeted service level at 1-800 MEDICARE is an 8 minute average speed of answer (ASA) as measured over the month.
At an 8 minute ASA, the majority of calls are answered between 3 – 26 minutes.
For September 2007, the ASA was 7 minutes 43 seconds and 80% of the calls were answered in less then 10 minutes. 

**10:00 a.m. – 2:00 p.m. is traditionally the busiest hours during the day.   **
- 4:30 p.m. – 6:00 p.m. are usually the busiest hours for Claims
**The budgeted service level at 1-800 MEDICARE is an 8 minute average speed of answer (ASA) as measured over the month.**
- At an 8 minute ASA, the majority of calls are answered between 3 – 26 minutes.
**For September 2007, the ASA was 7 minutes 43 seconds and 80% of the calls were answered in less then 10 minutes. **

**Current Call Centers**

## 1-800 MEDICARE Call Center Actions to Manage Call Waits

**Monitored and adjusted CSR shifts to match the call arrival patterns. **
**Implemented All Hands on Deck to ensure that we focus all resources on incoming calls during the most vulnerable period**
**Deployed call back process using strict guidelines when service levels reach certain levels – 20 minutes on average in any queue. **
- Individuals are called back within 48 hours.
**Training all CSRs on at least one Claims line of business (i.e. Part A, B, or DME) to handle claims calls.**
**Identifying system and process changes to reduce calls and improve call handling**

## 1-800 MEDICARE Average Speed of Answer FY 2007

## Quickest Way to Get to An Agent

|  | If you say .... at the Main Menu. | You get... |
| --- | --- | --- |
|  | Agent – Agent (General Questions) | General Medicare CSR |
|  | Doctor Services | Part B CSR Tier 1 |
|  | Hospital Stay | Part A CSR Tier 1 |
|  | Medical Supplies | DME CSR Tier 1 |

**Quickest Way to Get to An Agent**

## Interactive Voice Response Unit

**We have increased the automated capabilities on our IVR so that it can provide much of the same information that is available online at MyMedicare.gov.  This includes:  **
- Providing Part A, Part B, and DMERC claim information
- Providing Part B deductible information
- Checking Part C and D enrollment and LIS status

## 1-800 MEDICARE Customer Service Representatives

** **

**Developed a list of activities that describes what 1-800-MEDICARE CSRs can and cannot perform. **
** **
**These are being shared with SHIPs, partners, and RO caseworker staff.**

- * These activities can be performed by SHIP counselors and beneficiaries
- Using _[www.medicare.gov](http://www.medicare.gov/)__ web tools_

## 1-800 MEDICARE & SHIP Interaction

**Members from OBIS met with the SHIP Executive Steering Committee members on October 4 to provide members with insight regarding the 1-800 MEDICARE program and operation.   **
**OBIS staff reviewed all entries from the SHIP logs created in August. **
**OBIS identified several ***Next Step*** items:**
**Provide SHIPs with an overview of the 1-800 MEDICARE program and to educate counselors on which actions 1-800 MEDICARE CSRs Can and Cannot perform.**
**Provide education on CMS processes for specific topic areas that appeared problematic from the log entries. **
**We will work closely with several SHIPs to pilot strategies to improve SHIP/1-800 interactions.**
**Look at additional opportunities to create SHIP desktop references that counselors can use to assist with their interactions with 1-800.**

## Accuracy and Quality Call Monitoring

**Each CSR receives one hour of refresher training a week.  **
**Row meetings occur in which the Supervisors conducts a brief 5-15 minute meeting before the shift starts on hot topics or new issues.**
**The call center will release User Alerts and perform desk-to-desk updates when an issue requires critical and immediate attention.  **
**The call center has the ability to release a mass broadcast to CSR via the CSR desktop. **
**Each CSR is monitored and scored 4 times a month for Quality Assurance.  Based on scores and training, some CSRs will receive additional Quality Call monitoring.    **
**Where applicable, the Supervisors provide direct feedback and coaching to CSR based on Quality Call Monitoring.  **
**Quality Assurance – Call monitoring ensures CSRs are using the desktop and are providing callers with accurate, consistent and customer friendly service.  The need to coach and provide refresher training will be identified through Quality Assurance.      **