Common use of Member Hotline Clause in Contracts

Member Hotline. (3 pages, plus 2 additional pages per additional MCO Program bid if the Respondent’s response differs by MCO Program; excluding hotline telephone reports) The Member Hotline requirements are described in Section 8.1.5.6. Describe the proposed Member Hotline function, including: 1. normal hours of operation; 2. number of Member Hotline staff, expressed in the number of full time employees (FTEs) per 1000 Members who are available 8:00 a.m. to 5:00 p.m., local time in the Service Area, Monday through Friday, excluding state-approved holidays; 3. routing of calls among Member Hotline staff to ensure timely and accurate response to Member inquiries; 4. responsibilities of Member Hotline staff, if any, in addition to responding to HHSC Member Hotline calls, (e.g., responding to non-HHSC Member calls and/or HHSC Provider Hotline or Behavioral Health Hotline calls); 5. after-hours procedures and available services, including those provided to non-English speaking Members in Major Population Groups; 6. the number and percentage of FTE Member Hotline staff who are bilingual in English and Spanish; 7. the number and percentage of FTE Member Hotline staff who are multi-lingual for any additional language, by language spoken; 8. for STAR+PLUS only, the number and percentage of FTE Member Hotline staff dedicated to the Service Coordination function; 9. Member Hotline telephone reports for the most recent four (4) quarters with data that show the monthly trends for call volume, monthly trends for average speed of answer (where answer is defined by reaching a live voice, not an automated call system) and monthly trends for the abandonment rate; and 10. Whether the Member Hotline has the capability to administer automated surveys to callers at the end of calls. A Respondent currently participating in any of HHSC’s MCO Programs must submit the information in #9 above for each Member Hotline operated, and identify any proposed changes to hotline functions. If the Respondent is not currently participating in any of HHSC’s MCO Programs, it should describe its experience and proposed approach in establishing and maintaining an accessible call center for Members that is comparable to the Member Hotline described in Section 8.1.5.6. Such a description must include the information listed in items 1 to 10 above. A Respondent proposing to participate in more than one (1) MCO Program should note that it is not required to operate separate STAR, STAR+PLUS, and CHIP Member Hotlines, if it meets the RFP Member Hotline requirements for all MCO Program bid. If a Respondent is submitting a multi-program response to this RFP, the Respondent should separately describe each proposed Member Hotline, or if proposing to staff a single Member Hotline for multiple programs, and should note the differences, if any, in its Member Hotline and staffing for each MCO Program bid.

Member Hotline. (3 pages, plus 2 additional pages per additional MCO Program bid if the Respondent’s response differs by MCO Program; excluding hotline telephone reports) The Member Hotline requirements are described in Section 8.1.5.6. Describe the proposed Member Hotline function, including: 1. normal hours of operation; 2. number of Member Hotline staff, expressed in the number of full time employees (FTEs) per 1000 Members who are available 8:00 a.m. to 5:00 p.m., local time in the Service Area, Monday through Friday, excluding state-approved holidays; 3. routing of calls among Member Hotline staff to ensure timely and accurate response to Member inquiries; 4. responsibilities of Member Hotline staff, if any, in addition to responding to HHSC Member Hotline calls, (e.g., responding to non-HHSC Member calls and/or HHSC Provider Hotline or Behavioral Health Hotline calls); 5. after-hours procedures and available services, including those provided to non-English speaking Members in Major Population Groups; 6. the number and percentage of FTE Member Hotline staff who are bilingual in English and Spanish; 7. the number and percentage of FTE Member Hotline staff who are multi-lingual for any additional language, by language spoken; 8. for STAR+PLUS only, the number and percentage of FTE Member Hotline staff dedicated to the Service Coordination function; 9. Member Hotline telephone reports for the most recent four (4) quarters with data that show the monthly trends for call volume, monthly trends for average speed of answer (where answer is defined by reaching a live voice, not an automated call system) and monthly trends for the abandonment rate; and 10. Whether the Member Hotline has the capability to administer automated surveys to callers at the end of calls. A Respondent currently participating in any of HHSC’s MCO Programs must submit the information in #9 above for each Member Hotline operated, and identify any proposed changes to hotline functions. If the Respondent is not currently participating in any of HHSC’s MCO Programs, it should describe its experience and proposed approach in establishing and maintaining an accessible call center for Members that is comparable to the Member Hotline described in Section 8.1.5.6. Such a description must include the information listed in items 1 to 10 above. A Respondent proposing to participate in more than one (1) MCO Program should note that it is not required to operate separate STAR, STAR+PLUS, and CHIP Member Hotlines, if it meets the RFP Member Hotline requirements for all MCO Program bid. If a Respondent is submitting a multi-program response to this RFP, the Respondent should separately describe each proposed Member Hotline, or if proposing to staff a single Member Hotline for multiple programs, and should note the differences, if any, in its Member Hotline and staffing for each MCO Program bid.