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VNSNY CHOICE

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VNSNY CHOICE Clinicians Receive Specialized Elder Abuse Training

August 2, 2018–Each year, approximately 120,000 New York City seniors are victims of elder abuse*—a term that includes not only physical violence but also psychological mistreatment, neglect, sexual abuse, and financial exploitation. Because such abuse is often perpetrated by a close family member, however, victims can be reluctant to speak out. In fact, it’s estimated that less than one in 20 of these elder abuse cases actually get reported to the authorities.* To combat this problem, VNSNY requires all the home health aides (HHAs) it works with—from Partners in Care and from other agencies—to be trained and certified to identify and report suspected cases of elder abuse. The organization also maintains an internal contract administrator who works with city and state officials to investigate any reported abuse cases involving VNSNY patients or plan members. In addition, VNSNY CHOICE Health Plans—which accounts for the large majority of VNSNY’s contracted HHA services—has now begun reinforcing

June/July 2018 CHOICE Commendations

July 10, 2018–Providing excellent customer service is something we should always strive for. Here are excerpts from some of the dozens of calls we receive each week from members thanking CHOICE staff for a job well done. The daughter of a CHOICE MLTC member phoned to express how grateful she was for the work of Member Services Representative Janel Cole, describing Janel as “courteous, expedient, and knowledgeable.” The son of a CHOICE MLTC member thanked Enrollment Coordinator Milagros Lopez for her “empathy and willingness” in assisting his father’s enrollment process. He added that VNSNY is “very lucky” to have an employee like Milagros, who “doesn’t only look to resolve concerns but also feels the desire to truly help people in need.” The daughter of a CHOICE member commended Member Services Representative Jia Luo for being “so warm” and for “making it easy” while correcting an issue concerning her mother’s care. Jia “did not pass

CHOICE SelectHealth Completes LGBT Training and Earns Platinum Certification from SAGE

June 7, 2018–SelectHealth, VNSNY CHOICE’s Special Needs Plan for HIV-positive Medicaid recipients, has been awarded Platinum-level certification from the Services and Advocacy for GLBT Elders (SAGE) organization—indicating that 80% or more of SelectHealth staff members have undergone SAGE’s cultural competency training. This training, known as SAGECare, is designed to increase awareness among clinical and administrative staff of cultural issues and sensitivities around sexual orientation and gender identification, in order to ensure a welcoming and respectful health care environment for all individuals within the LGBTQ community. By achieving Platinum SAGE certification, SelectHealth now joins VNSNY Hospice, VNSNY Home Care and Partners in Care, which have also been awarded SAGE Platinum-level status. “CHOICE continues to serve special populations,” notes Dr. Hany Abdelaal, President of VNSNY CHOICE, “and this certification ensures that our staff have the appropriate education and training for managing our newest members.”

May 2018 VNSNY CHOICE Staff Commendations

May 30, 2018–Providing excellent customer service is something we should always strive for. Here are excerpts from some of the dozens of calls we receive each week from members thanking CHOICE staff for a job well done. A member of CHOICE SelectHealth expressed his gratitude for the help provided by Member Services Representative Marlin Collado, stating that Marlin “assisted him efficiently and with care.” A CHOICE member phoned in to compliment the work of Member Services Representative Christine Odom. “Christine was very patient and did not rush me,” the member said. “She is very nice. She knows how to help older people, and has a great personality.” The son of another member also praised Christine, adding that he “is very happy with the services my mother has been getting from VNSNY CHOICE.” A CHOICE member’s daughter called to commend Member Services Representative Tatiana Domracheva for her helpfulness in resolving an ongoing issue. “We’re always quick

Going the Extra Mile: The CHOICE Member Services Call Center

May 30, 2018–One newly enrolled CHOICE member called with questions about her benefits. The daughter of another member phoned to check on the status of medical supplies that had been ordered for her father. A third member dialed in to arrange regular visits from a home health aide. Handling these types of requests is all part of a typical day’s work for the 83 Member Services Representatives (MSRs) at the VNSNY CHOICE Member Services Call Center, as they field upward of 3,100 calls to the center’s hotline each day from CHOICE plan members and their families.   Established in 2012, the center is the outward-looking “face” of CHOICE for the organization’s various product lines and other ancillary services. Its answer lines for the CHOICE Managed Long-Term Care (MLTC) and CHOICE SelectHealth plans are in operation 24/7, while the other CHOICE plans field calls during business hours of 8:00 a.m. to 8:00 p.m.

CHOICE SelectHealth Passes New York State Department of Health Targeted Survey

May 10, 2018–CHOICE SelectHealth, VNSNY CHOICE’s Special Needs Plan for HIV-positive Medicaid recipients, underwent a targeted, two-day survey by the New York State Department of Health earlier this week and emerged with no corrective actions required—meaning the health plan received perfect marks on all the operational aspects that the reviewers were examining. “In fact, the survey was originally scheduled for three days,” notes Maureen O’Leary, head of compliance for CHOICE SelectHealth, “but it went so well, the DOH inspectors concluded a day early.” The survey was looking primarily at how SelectHealth communicates with its members on matters related to utilization, such as authorization denials, and grievance and appeals issues—areas identified for improvement in the DOH’s full-scale survey of SelectHealth, conducted in 2017. “We also did extremely well on that 2017 survey, which lasted a week and was incredibly comprehensive,” says Maureen. “The fact that we had only a few limited areas that

Marki Flannery and Hany Abdelal Highlight Innovative VNSNY Integrated Care Models in Medium News Blog

April 27, 2018

April 2018 VNSNY CHOICE Commendations

April 25, 2018–Providing excellent customer service is something we should always strive for. Here are excerpts from some of the dozens of calls we receive each week from members thanking CHOICE staff for a job well done. A CHOICE Member phoned to compliment Member Services Representative Jessica Polanco on Jessica’s “excellent service” in helping her. “She was a pleasure to speak to,” the member added. “I am very grateful, and want to make sure everyone knows what wonderful and great service she provided.” A CHOICE MLTC member called to say that Member Services Representative Eblond Achile provided “exceptional” assistance with an issue the member was having. “Eblond is great with her customer service skills, and courteous,” she noted. A CHOICE member’s wife commended Member Services Representative Joy A. Brown for her “outstanding service.” The spouse explained that the couple had been dealing with several issues regarding supplies. “Joy went above and beyond to see the

The VNSNY CHOICE Provider Call Center: Ready for Any Challenge

April 11, 2018–Every weekday, from 8:00 a.m. to 5:00 p.m., a team of 22 skilled associates in the VNSNY CHOICE Provider Call Center respond to as many as 700 phone calls from VNSNY CHOICE Health Plans’ care providers. Wearing headsets and answering the calls on their “soft” phones (which send silent alerts directly from their computer screen), these adept VNSNY customer service representatives address the concerns of medical professionals ranging from doctors’ offices and hospitals to skilled nursing facilities and adult day care centers. The majority of the calls are related to the status of various claims, but when a Call Center CHOICE staffer answers with a friendly, “Thank you for calling VNSNY CHOICE Provider Services—how may I help you today?” she or he is ready to assist with whatever the challenge may be. If it’s a pharmacy calling, the customer service rep will redirect the call to a different help desk.