MCOL RELEASES E-POLL RESULTS ON IMPROVING
HEALTH PLAN MEMBER SERVICES
Telephone Reigns As Primary Communication Tool
MODESTO, CA, Nov. 13, 2000 --- MCOLÔ (mcol.com), the leading health care information technology company specializing in delivering business-to-business managed care knowledge resources, has just released electronic survey results from its more than 7,000 professional members of Managed Care On-LineÔ pertaining to their professional perspective on how health plans could improve member services.
Says Claire Thayer, Vice President of Research and Development, “In an era of managed care backlash, improving health plan member service is a critical issue for health plans. We conducted an e-poll of our members because key insight is gained from considering how those who know the inner workings of the system best, feel about member service processes and resources.”
Says Thayer, “In general, plans, providers and all others responding were in relative, and surprising agreement, on what the member services issues were, and how to deal with them. However, there were a few notable exceptions where respondents did not see eye to eye, and it is important to understand the differences in how plans, providers and other professionals view these issues.”
According to Thayer, the survey of plans, providers and other professionals indicate “The telephone still rules as the primary interface between a health plan and its members. Plans view the use of its web site as a much more important member service tool compared to how provider or other professionals feel about the web. Plans, providers and other professionals have very different views on the best recourse for members to address unresolved complaints. However, they generally agree on what the specific service problems are.”
Key findings from the survey include:
·
The telephone continues to far outdistance the web or other
mechanisms as the perceived single most effective member interface.
· Providers held less faith in the web than Plans or other respondents.
· When asked what was the single most effective means of pursuing an unresolved member problem, Plans gave significantly more weight to "using their internal complaint and grievance system," and much less weight than providers or other respondents did to "asking a member's employer or insurance agent to go to bat for them."
· When asked the same question, providers gave significantly more weight than plans or other respondents did to "filing a complaint directly with the plan's state regulator."
· Specialist Referrals (26%), Prescription issues such as formulary requirements (25%) and Use of non-participating providers (21%) -- outdistanced all other responses as the most stunning service issues that health plans still need to address to improve customer service.
· The "Speed of health plan’s claims payment process" (21%), and "How health plans interpret their benefit language" (17%), ranked as the top two responses regarding which plan/provider issues could single-handedly best improve a plan's service to its members.
· The "Plan Internal tracking systems regarding member problem resolution" (36%) and "Member Telephone response time" (33%) were the top two responses regarding which member service processes could most positively improve the member service function if health plans dedicated additional resources to that process.
· Plans ranked "Web Site customer service applications and information" as a close second choice to the above question, and ranked it significantly higher than Providers or Other respondents.
The detailed survey results are
available to Managed Care On-Line members in the MCOL web site. Representatives
of the media may obtain a full copy of the results upon request.
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