State Healthcare Business Services Automation
Contact Solutions automates the full range of Medicaid provider and member transactions. States that take advantage of our contact automation expertise and experience deliver measurable improvement in self-service and customer experience.
Robust Self-Service Functionality
Contact Solutions’ cloud–based service environment offers a full set of self-service functionality to achieve your program’s goals including:
- Multi-modal communication: Voice, SMS, Email, Web, Fax
- Dynamic, web-based control of scripts and caller routing
- Secure, HIPAA and SSAE compliant transaction processing
- Multi-factor identification and verification (ID&V)
- Integration with case management databases, PBX/ACD, and other IT systems
- Detailed and actionable business reporting and analytics
Business services we automate for Medicaid programs include:
| Caller Authentication | Verify members using multiple factors prior to authorizing access to personal information to ensure HIPAA requirements are met. |
| Eligibility Status | Make eligibility information available in an accurate and timely fashion. |
| Claims Status | Provide claim status (i.e. paid or denied) and reason for denial or additional information required to complete claim process. |
| Service Limits | Deliver details on coverage limitations (i.e. number of PT sessions allowed, coverage limits, etc.) prior to requesting or providing services. |
| ID Card Replacement | Process card replacement requests and verify addresses on file to reduce processing fees and minimize human error. |
| FAQs | Provide accurate and consistent responses to frequently asked questions; minimizing human error associated with interpretation of regulations. |
| Dynamic Messages | Temporary messages can be created and turned on or off in real time to provide critical program/system updates in a cost effective manner. |
| Payment Services | Provide detailed information about claims processed during the payment period and offer payment via phone or web. |
| Automated Reminders | Offer outbound reminders for payments or paperwork due or notification of case status changes via telephone or text message. |