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SCAN - Customer Service Department of the Year


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Company: SCAN, Long Beach, CA
Entry Submitted By: Havas Formula
Company Description: SCAN is a not-for-profit organization that is committed to keeping seniors healthy and independent. SCAN has delivered on this mission since 1977 through SCAN Health Plan, one of the largest not-for-profit Medicare Advantage plans in the nation. SCAN also offers education programs, community funding, volunteer opportunities and other community services throughout our California service area.
Nomination Category: Customer Service Categories
Nomination Sub Category: Customer Service Department of the Year

Nomination Title: SCAN’s Member-Centric Customer Service Department

Tell the story about what this nominated organization/department has achieved since January 1, 2016 (up to 650 words). Focus on specific accomplishments, and relate these accomplishments to past performance or industry norms. TEXT REDACTED FOR PUBLICATION

SCAN is a not-for-profit organization that is committed to keeping seniors healthy and independent. SCAN has been fulfilling this mission for 40 years and its dedication to the senior community is reflected through its customer service focus, including an award-winning member contact center.

SCAN Health Plan’s contact center has achieved a 95 percent satisfaction rate from customers and achieved all of its call performance goals for every month in 2016. This includes a service level goal of 80 percent of calls answered in 30 seconds or less and a call abandon rate of 5 percent or less. SCAN’s Member Service Advocates are well-trained and equipped to handle a variety of call types, from simple benefit questions to detailed pharmacy coverage to help choosing a new physician. Unlike many call centers, SCAN does not have a maximum call time. Member Service Advocates know that they can spend as much time with each caller as necessary to answer questions and leave them reassured.

SCAN’s Member Service Advocates are also skilled at offering the appropriate members more specialized service, depending on their needs – including the Medication Adherence and “My Advocate” programs. The Medication Adherence program promotes member wellness by educating and encouraging members to take their medications as prescribed. SCAN Advocates have access to members’ prescription history and can help address any barriers keeping members from taking these important medications as directed.

This effort aligns with the Centers for Medicare and Medicaid Services (CMS) 5-Star Rating program for health plans. This program measures Medicare plans’ ability to provide quality service to members in areas including customer care, ease of making appointments, and ensuring members are adhering to their medications.

Additionally, through the “My Advocate” program, SCAN partners with a company that offers member assistance to determine their potential eligibility for Extra Help, a Medicare Savings Program. This provides savings to members by helping to pay for Medicare Part A and Part B premiums and Part D prescription premiums and deductibles. It also helps with utility costs and other necessities. There is no cost associated with My Advocate and SCAN members have expressed tremendous gratitude for this help.

SCAN’s member engagement doesn’t end with the contact center. “Straight TeleTalks” are large-scale conference calls that provide SCAN members the opportunity to hear from Member Service Advocates, SCAN senior executives and clinical experts, on various topics. In 2016, TeleTalk topics included: tips for taking (and saving money on) prescription medications, myths and facts about mental health—a topic which generated moving messages of thanks from attendees— and education on the coming year’s benefit changes.

SCAN members also participate on the company’s Senior Advisory Council. This group meets regularly with SCAN representatives and executives to provide feedback on SCAN plans and give participants an opportunity to learn more about items that impact them, such as navigating the new SCAN website.

The plan also provides tools to help members make the most of their health plan. SCAN’s Health Check Record, updated and mailed annually, provides each member a customized record of their medical care, along with helpful tips and resources. And the SCAN Club newsletter is mailed to members every other month and includes plan information and health reminders.

Unique to SCAN is the Senior Advocate team. These part-time employees are also SCAN members. In addition to ensuring members are front-and-center at the company every day, they also do special outreach campaigns. They call and welcome new members to the plan and explain benefits, field questions during Straight TeleTalk events, and call each and every member on their birthday.

As an organization, SCAN Health Plan is committed to providing members with personalized support. Its Member Services department is on the front-line of all these efforts, talking with members, making a connection, and fulfilling SCAN’s mission: keeping members healthy and independent.

In bullet-list form, briefly summarize up to ten (10) accomplishments of the nominated department since the beginning of 2016 (up to 150 words).

• Serves 186,000 health plan members in California
• Ranks among the largest Medicare Advantage plans in the nation
• Provided the community with $10 million through community service initiatives
• Spent $686,544 on community giving, including grants to non-profit senior service organizations
• Recognized as a 2017 International Customer Management Institute (ICMI) award finalist
• 2017 marks the organizations’ 40-year anniversary; SCAN was founded in Long Beach, Calif., by a group of 12 seniors determined to improve access to senior health services