Elisa Elderbaum

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Elisa Elderbaum
Collecting, Managing, Analyzing User Feedback

• IT Business Advisor
• National Government Services, formerly Empire
  Medicare Services

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Agenda

• Introduction - National Government Services
• Reports
• Compliance Reports
• Operations Reports
• Continuous Improvement
• Lessons Learned
• Future Improvements

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• National Government Services

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National Government Services

• Serves over 22.5 million people with Medicare in
  26 states
• In 2006, responded to 10.4 millions calls
• Processed over 208 million Medicare claims and
  administered benefits of more than 87.9 billion
• Currently at 240 ports
• Contact center locations
• Syracuse, NY
• Bohemia, NY
• Harrisburg, PA
• Milwaukee, WI
• Indianapolis, IN
• Manchester, NH
• Cincinnati, OH

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Medicare Insurance Programs

• Part A Medicare Hospital Insurance (Hospitals)
• Part B Medicare Supplementary Medical Insurance
  (Doctors Offices)
• Part C Medicare HMO Program
• Part D Medicare Prescription Drug Benefit

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Self-Service Options

• Medicare Part A
• Patient Eligibility
• Claims Status
• Financial Information (Check Remittance)
• Commonly Requested Telephone Numbers
• Commonly Requested Addresses
• Commonly Requested Websites
• Hours of Operation
• Seminar Information
• HMO Information
• Appeal Rights

• Medicare Part B
• Patient Eligibility
• Claims Status
• Patient Deductible Status
• Procedure Code Pricing
• Seminar Schedules
• Earnings
• Commonly Requested Telephone Numbers
• Commonly Requested Addresses
• Fax-On-Demand Information
• Appeal Rights

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Reports

• Compliance Reports
• Operations Reports
• Continuous Improvement
• Dashboard

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Compliance Reports
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Compliance Reports

• The Centers for Medicare and Medicaid Services
  (CMS) have established Service Level Agreements
  that contractors must meet
• National Government Services submits these weekly
  reports externally to CMS to remain in compliance

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Compliance Reports
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Operations Reports
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Operations Reports

• Reports used internally for day-to-day
  maintenance of the systems
• IVR Port Utilization
• Application Failure Report
• Host Transaction Failure Report

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IVR Port Utilization
Daily IVR Port Utilization
Report Period 07/01/07 07/07/07
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Port Utilization Trends
IVR Port Utilization
2007 YTD
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Backend Transaction Failures
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Continuous Improvement
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Continuous Improvement

• Reports are generated daily, weekly and monthly
  for to track IVR activity
• Augments automation by identifying areas for
  improvement critical to the success of automation
• Reports are used internally to identify
  improvement areas
• Reports are also used externally as a continuous
  education process

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Completed Transaction Summary
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Failed Transaction Summary
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Failed Transactions by Provider
Failed Transactions by Provider
X1
X5
X4
X1 X2 X3 X4 X5
X3
X2
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Lessons Learned
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Lessons Learned

• Improvement is a continuous process
• Empower your live agents
• Teach them the automated system so they can teach
  your callers
• Listen to your callers factor in their wants
  needs into your improvement plans
• Treat automated agents like live agents
• Train and refine the automated agent
• Use IVR system reports to help guide the
  improvement process
• Technology can only take you so far
• Analyze the data dont wait until the end of
  the project. Understand what it means

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Future Improvement
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Future Improvement

• Dashboard
• Single real-time, view of entire system by
  application, backend, and system perspective
• Trend Analysis
• Analyze trends in call volume, call types, system
  utilization, etc
• Allows for point or spot analysis

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• THANK YOU!
• Elisa Elderbaum
• IT Business Advisor
• National Government Services