Provider Services

In addition to providing Enrollment Services to carriers on an outsource basis, Connect One Health’s Dedicated Services Division (“DSD”) also provides outsource services to providers in the Medicare industry, including hospital systems and individual hospitals, physician practice groups (“PPGs”), and companies who manage PPGs (collectively, “Provider Services.” 

The DSD currently offers the following Provider Services on an outsource basis:

Enrollment Services for Medicare Advantage Plans, Medicare Supplement Plans, and Prescription Drug Plans.  The DSD works directly with Providers as their “preferred broker” for their patients. Please see below for a representative example of how that process works.

Inbound Customer Service.  Some Providers require outsourced assistance for basic Customer Service functions. The DSD Team works with the Provider to understand its Customer Service needs, deficiencies, and/or “wants,” and to develop a Provider-approved Customer Service plan for the provision of such services. The DSD Team then trains and manages licensed agents or employees (depending on the requirements of the Provider) to staff its Customer Service department.

Outbound Customer Service.  Although most Providers have an internal customer service team that handles typical inbound calls from patients, there are other times when the Provider wants or needs to initiate an outbound call program that exceeds the current capabilities or available time of its internal Customer Service team.  Examples include patient satisfaction outreach programs.  The DSD team can supply and manage outsourced labor for such campaigns. 

Management Consulting Services.  Although the DSD Team’s primary function is to outsource labor to Providers to assist with Enrollment Services or Customer Service functions, the DSD Team has also evaluated Providers’ internal Customer Service teams and practices to identify deficiencies, areas for improvement, and/or to determine whether outsourcing is the more cost-effective model.

Specific examples of the DSD Team’s Provider experience include:

• Staffing and operating a “Medicare Educational Resource Center” to provide Educational Services to patients of several PPGs.  The agents who staffed the Center educated the patients on the basics of Medicare, assisted the patients in navigating through some of the more technical aspects of the Medicare system and, if the patient requested enrollment services, directed the patient to the preferred Medicare broker of the particular PPG.

• Training and managing a team of licensed agents to work exclusively on behalf of specific PPGs, as their “preferred” Medicare broker.  By working with the PPGs to understand their patients’ Medicare needs by demographic, as well as the specific needs of their patients, the DSD team was able to provide patients of the PPGs with “concierge-level” service on all things Medicare, including Educational Service and Enrollment Services.  Doing so led to more efficient benefit meetings between the agents and the patients (i.e., less time on the phone), and higher patient satisfaction with the enrollment experience.

• Assisting several PPGs during the Annual Enrollment Period with an urgent project that exceeded the capabilities of their combined customer service teams. Specifically, the PPGs had advised their patients of certain changes in the Medicare insurance coverage they would be accepting during the upcoming plan year. Due to the unexpected volume of calls that the announcements generated, and the fact that the PPGs’ staff were not properly trained to address the substance of the patients’ Medicare questions (including, potentially, discussions of benefits), the PPGs engaged the DSD Team to provide licensed agents to work on behalf of the PPGs. Within a week of being engaged, the DSD licensed agents were acting as direct extensions of the PPGs, answering all calls generated by the announcements, and resolving all patient Medicare-related questions.

If you are interested in exploring how Connect One’s Dedicated Services Division can help your business, please contact Connect One’s Chief Executive Officer, John C. Barnoski on LinkedIn, or by email at jbarnoski@connectonehealth.com.