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CIGNA Government Services

ABA11 Winner / How to Enter

Company: CIGNA Government Services, LLC
Company Description: CIGNA Government Services (CGS) contracts with the Centers for Medicare & Medicaid Services (CMS) to process Medicare claims for more than 16 million beneficiaries and more than 80,000 providers/suppliers. CGS exceeds CMS expectations with a focus on controlling costs to maintain the integrity of the Medicare Trust Fund. CGS must also comply with federal rules, regulations, and CMS requirements.
Nomination Category: Customer Service Awards Categories
Nomination Sub Category: Customer Service Department of the Year

Nomination Title: Customer Service – We IMPACT Lives!

    Tell the story about what this nominated organization/department achieved since January 1 2010 (up to 500 words). Focus on specific accomplishments, and relate these accomplishments to past performance or industry norms. Be sure to mention obstacles overcome, innovations or discoveries made, and outcomes:

        The Core Values of CGS are Integrity, Making a Diffference, Passion for
Excellence, Always Improving, Customer Focus and Taking Risks. These values
combine to form the acronym, IMPACT. IMPACT is represented in our Mission, “We
IMPACT lives”, and our vision, “To IMPACT the future of our communities and
nation by being the premiere administrator of government healthcare programs.”
Through personification of these core values, CGS’ Provider Contact Center
(PCC) enables us to realize our mission and vision, by positively impacting the
lives of millions of government healthcare beneficiaries, providers and
suppliers, everyday. 

        CGS has provided services to CMS since Medicare began in 1966. In June 2007,
CGS was awarded the largest of four Durable Medical Equipment (DME) Medicare
Administrative Contracts to provide claims processing, Provider Customer
Service Program (PCSP) and administrative services to more than 80,000 DME
suppliers in 17 U.S. states and territories. CGS’ PCSP is comprised of the
multi-tiered customer service organization, Congressional inquiries,
Beneficiary Complaint Screening,  Written Correspondence, and our Provider
Outreach and Education (POE) team, which provides education and clarification
to providers regarding CMS regulations.

        Customer Service provided by our PCSP, includes less than 100 employees who
ensure the over 13 million medicare beneficiaries we serve receive the medical
equipment they need while the over 80,000 suppliers of that medical equipment
receive payment – all while meeting or exceeding federal performance. The
agents respond to more than 56,000 customer inquiries per month from Medicare
providers. Throughout 2010, including during the Nashville flood in May 2010,
Customer Service demonstrated unparalleled customer focus by not only achieving
CMS goals, but exceeding them.

        Metrics                                                         CMS Goal            May 2010 (flood)    December
Average Speed of Answer   = 60 Seconds      17 sec                    20 Sec
Customer Service Skills                          93%                        100%                     100%
% of Call Backs Compeleted                99.5%                    100%                     100%
On Time
% Knowledge skills                  93%                        95.5%                    96.0%
Call Completion Rate                              80%                        98.8                        99.0%


        Some examples of the PCC’s IMPACT on our customers include:

        • # 1 in Provider Satisfaction, according to the CMS Medicare Carrier
Provider Satisfaction Survey.
• Exceptional customer service quality as evidenced by our month-over-
month Quality Call Monitoring, Direct Call Monitoring, and Quality Written
Correspondence Monitoring results reported to CMS.
• PCC staff implemented concierge level of service to educate our
customers and reduce excessive inquiries. CGS designates individual points of
contact to customers who routinely land on our “heavy hitter” list.  These
designees successfully helped to reduce call inquiries through effective
education and support.
• Tracking History & Online Reporting (THOR) system enables the PCC to
track and trend all telephone data, proactively identifying potential
operational issues impacting customer satisfaction and identifying the need for
additional external customer education and internal agent training.

        Additional Accomplishments:

        • PCC Representatives completed more than 8,640 hours of internal
training throughout the year
• POE team conducted 286 webinars, educating 2719 providers. This staff
of 6 hosted 32 contractor sponsored face-to-face workshops for more than 1100
participants. In 2010, the provider satisfaction for our education
opportunities was 97.8%.

    List hyperlinks to any online news stories, press releases, or other documents that support the claims made in the section above. IMPORTANT: Begin each link with http://, and enclose each link in square brackets; for example, []:!!/CGS.J15

    Provide a brief (up to 100 words) biography about the leader(s) of the nominated organization/department:

        John Kelly is the DME Provider Customer Service Program Manager. He has been
with CGS for 14 years. He has a Bachelors degree in Mass Communication from
Western KY University. He is an experienced professional with expertise in
government health care, marketing, communications, Medicare Fee-for Service
Operations, government contracting, and management. 

        Prior to coming to CGS, John worked as a producer/writer/director in
entertainment television.  He once turned down the opportunity to study with
the Royal Shakespearean Company of London. He currently spends his free time,
when he has it, playing with his two pugs.