Exhibit_30_Member_Services_Reports.xlsx
XLSX spreadsheet 49 KB Posted
- Attached to
- OEIBA Program Commercial HMO, MSP, and MAPD Plans State and local contract opportunity
- Solicitation number
- EV00000681
- Issued by
- Oklahoma County, Hobart City, Oklahoma
About this file
This is an Excel exhibit (Exhibit 30) for Member Services Reports related to an OEIBA (Oklahoma Employee Insurance Benefits Act) program, covering reporting requirements for Health Maintenance Organization (HMO) and Medicare Advantage Prescription Drug (MAPD) member services. The document outlines detailed reporting standards for telephone assistance and member satisfaction surveys, with monthly, quarterly, and annual reporting deadlines consistently set at the 20th of the following month or 60 days after quarter/year-end. The reporting requirements mandate specific performance metrics, including an 80% target for answering calls within 30 seconds and maintaining a call abandonment rate under 5%.
The reports require comprehensive data tracking across multiple dimensions, including average telephone answer time, hold time, call length, total calls, abandonment rates, and first call resolution rates. For the member satisfaction surveys, suppliers must provide an executive summary, describe member dissatisfaction areas, and detail survey methodologies. All reports must be submitted electronically via a secure email domain (EGIDVendorReporting@omes.ok.gov), with the HMO and MAPD telephone and survey reports requiring distinct tracking and submission. The documentation emphasizes continuous performance monitoring and annual survey analysis to assess and improve member service quality.
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Text version
Report Cover
| Exhibit 30: Member Services Reports |
| [Supplier Name] |
| OEIBA Program |
| [Date] |
| Report | Report Title | Tab Name |
| 30a | Member Services Telephone Assistance | HMO Telephone |
| 30b | MAPD Member Services Telephone Assistance | MAPD Telephone |
| 30c | Member Satisfaction Survey Results | HMO Survey |
| 30d | MAPD Member Satisfaction Survey Results | MAPD Survey |
| Notes: |
| 1) Send via email by a secure domain to: EGIDVendorReporting@omes.ok.gov |
| 2) Completed template for 30a and 30b must be submitted electronically as an Excel file. 30c and 30d may be submitted in another format but must be labeled appropriately. |
30a HMO Telephone
| Due Date for Monthly Reporting | 20th of the following month |
| Due Date for Quarterly Reporting | 60 days following the close of the calendar quarter |
| Due Date for Annual Reporting | 60 days following the close of the calendar year |
| Member Services Telephone Assistance | |
| [Supplier Name] | |
| Reporting Date [Date Start - Date End] |
| Jan (example) | Jan | Feb | Mar | Qtr 1 (Jan 1-Mar 31) | Apr | May | Jun | Qtr 2 (April 1-June 30) | Jul | Aug | Sep | Qtr 3 (July 1-Sept 30) | Oct | Nov | Dec | Qtr 4 (Oct 1-Dec 31) | Plan Year Annual Results (Jan 1-Dec 31) | |
| Average telephone answer time (in seconds) | 25 | |||||||||||||||||
| Average telephone hold time (in seconds) | 18 | |||||||||||||||||
| Average length of call (in minutes) | 3.2 | |||||||||||||||||
| Total abandoned calls (hang-ups) | 15 | |||||||||||||||||
| Average abandonment rate for customer service calls | 3% | |||||||||||||||||
| Total calls | 500 | |||||||||||||||||
| Total calls within 30 seconds or less | 145 | |||||||||||||||||
| Percentage of customer service calls answered in 30 seconds or less | 91% | |||||||||||||||||
| First call resolution rate | 96% | |||||||||||||||||
| Notes: Refer to Attachment A section D.28. |
The Supplier’s customer service telephone response performance must meet the below standards for each month of each Plan Year:
The Supplier shall answer at least eighty percent (80%) of all calls in thirty (30) seconds or less;
The average call abandonment rate shall not exceed five percent (5%).
30b MAPD Telephone
| Due Date for Monthly Reporting | 20th of the following month |
| Due Date for Quarterly Reporting | 60 days following the close of the calendar quarter |
| Due Date for Annual Reporting | 60 days following the close of the calendar year |
| MAPD Member Services Telephone Assistance | |
| [Supplier Name] | |
| Reporting Date [Date Start - Date End] |
| Jan (example) | Jan | Feb | Mar | Qtr 1 (Jan 1-Mar 31) | Apr | May | Jun | Qtr 2 (April 1-June 30) | Jul | Aug | Sep | Qtr 3 (July 1-Sept 30) | Oct | Nov | Dec | Qtr 4 (Oct 1-Dec 31) | Plan Year Annual Results (Jan 1-Dec 31) | |
| Average telephone answer time (in seconds) | 25 | |||||||||||||||||
| Average telephone hold time (in seconds) | 18 | |||||||||||||||||
| Average length of call (in minutes) | 3.2 | |||||||||||||||||
| Total abandoned calls (hang-ups) | 15 | |||||||||||||||||
| Average abandonment rate for customer service calls | 3% | |||||||||||||||||
| Total calls | 500 | |||||||||||||||||
| Total calls within 30 seconds or less | 145 | |||||||||||||||||
| Percentage of customer service calls answered in 30 seconds or less | 91% | |||||||||||||||||
| First call resolution rate | 96% | |||||||||||||||||
| Notes: Refer to Attachment A section D.44. |
The Supplier’s customer service telephone response performance must meet the below standards for each month of each Plan Year:
The Supplier shall answer at least eighty percent (80%) of all calls in thirty (30) seconds or less;
The average call abandonment rate shall not exceed five percent (5%).
30c HMO Survey
| Due Date | 60 days following close of calendar year |
| Member Satisfaction Survey Results | |
| [Supplier Name] | |
| Reporting Date [Date Start - Date End] |
| *Provide and/or attach a copy of your annual survey results January 1- December 31 of Plan Year. | |
| Requirements | Response |
| Provide an executive summary of the results. | |
| Describe what the Supplier's members are least satisfied with (i.e., provider network, customers services, plan benefits, etc.) and why. | |
| Describe the frequency and methodology (i.e., telephone, mailing, electronic, etc.) of the Supplier’s member satisfaction surveys. |
Note: The Supplier shall conduct a member satisfaction survey at least annually that compiles and analyzes its survey results for submission. Plan Year specific survey requirements are located in the Attachment A in section D.29. "Member Satisfaction."
30d MAPD Survey
| Due Date | 60 days following close of calendar year |
| MAPD Member Satisfaction Survey Results | |
| [Supplier Name] | |
| Reporting Date [Date Start - Date End] |
| *Provide and/or attach a copy of your annual survey results January 1-December 31 of Plan Year. | |
| Requirements | Response |
| Provide an executive summary of the results. | |
| Describe what the Supplier's members are least satisfied with (i.e., provider network, customers services, plan benefits, etc.) and why. | |
| Describe the frequency and methodology (i.e., telephone, mailing, electronic, etc.) of the Supplier’s member satisfaction surveys. |
Note: The Supplier shall conduct a member satisfaction survey at least annually that compiles and analyzes its survey results for submission. Plan Year specific survey requirements are located in Attachment A in section D.46. "Member Satisfaction."
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