DCS Comprehensive Health Plan

Telephone Performance Standards

Statement/Purpose

The Department of Child Safety (DCS) Comprehensive Health Plan (CHP) has established service standards when handling member and provider telephone calls.

Definitions

Average Speed of Answer (ASA): The average on line wait time in seconds that the member/ provider waits from the moment the call is connected in the Contractor’s phone switch until the call is picked up by a Contractor’s representative or Interactive Voice Recognition System (IVR).

Department of Child Safety (DCS): The regulatory oversight body of the Managed Care Organization (MCO)

Mercy Care DCS/CHP: The contracted Managed Care Organization (MCO).

Monthly Average Abandonment Rate (MAAR): The number of calls abandoned in a 24-hour period, divided by the total number of calls received in the same 24-hour period, summed for each day of the month and then divided by the number of days in the monthly reporting period.

Monthly Average Service Level (MASL): The total of the month’s calls answered within 45 seconds divided by the sum of the following: all calls answered in the month, all calls abandoned calls in the month and all calls receiving a busy signal in the month (if available).

Monthly First Call Contact Resolution Rate: The sum of the DFCCRs divided by the number of days in the reporting period.

Policy

DCS CHP maintains established telephone performance standards to ensure member and provider service satisfaction. Incoming calls to DCS CHP and Mercy Care DCS CHP centralized customer service telephone lines are tracked and reviewed to ensure compliance with the established performance measures.

Procedure

Service Standards for DCS CHP and Mercy Care DCS CHP

DCS CHP has established the following telephone performance measures for incoming member and provider telephone calls:

• ASOA, 45 seconds or less

• MAAR, 5% or less

• MFCCR, 70% or better

• MASL, 75% or better

Continuous improvement techniques are implemented to identify opportunities to improve these measures even when standards are met.

Reporting Telephone Performance Standards

Periodic reports are generated and reviewed to ensure performance standards are met.

AHCCCS Telephone Performance Measures Template, Worksheet A, is used to document ASOA, MAAR, MFCCR, and MASL for each customer service representative. Telephone Line Down Time Template, Worksheet B, is used to report down time for DCS CHP’s centralized telephone line. The template includes dates of the occurrence and the length of time the line was out of service.