Member Services Telephone System. The MCO must develop and implement member services call center policies and procedures that address staffing, training, hours of operation, access and response standards, transfers/referrals, including referrals from all sources, monitoring of calls via recording or other means, translation/interpretation, and compliance with standards. The MCO must provide member services to members through a toll-free telephone system. The MCO's member services telephone system must have services available to assist: Members who are hard of hearing (i.e., TTY/TDY); and Members with limited English proficiency in the primary language of the member. The MCO must have the capability for ODM or its designee to monitor calls remotely. The MCO must have the capability to capture "audio signatures" for any required forms or requests that require the member's signature. The MCO must measure and monitor the accuracy of responses provided by MCO call center staff and take corrective action as necessary to ensure the accuracy of responses by staff.
Appears in 4 contracts
Samples: Ohio Medicaid Provider Agreement for Managed Care Organization, Ohio Medicaid Provider Agreement for Managed Care Organization, Ohio Medicaid Provider Agreement for Managed Care Organization
