The VNSNY CHOICE Provider Call Center: Ready for Any Challenge

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.

Francine Noyan, Supervisor of Provider Services at the CHOICE Provider Call Center.

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. If it’s a hospital calling about a claim, the rep may guide the caller to the CHOICE online portal. Whatever the inquiry, the reps are well versed in their “ownership statement” or “script” for efficiently getting the provider’s concerns addressed.

This smooth-functioning department reflects a culture of ongoing monitoring and coaching. Melody Kombo, who until recently was Manager of the VNSNY CHOICE Provider Call Center, helped set up this structure last year, when VNSNY decided to bring the center in-house.

Thinking on their feet: Giovanni Baquero, CHOICE Provider Service Associate.

She wrote the policy and procedures, training manuals and quality requirements, hired the center’s associates and oversaw their education process, guiding them in keeping callers “on point”—an essential task, given that a single associate may handle more than 50 calls in a day. Besides the ability to multitask and type fast, the job requires a certain type of personality, says Melody. “Most of all, a Call Center rep needs to be able to listen,” she notes.

Kendrick Chow, who along with Francine Noyan took over management of the Call Center this spring when Melody transferred to work with CHOICE Network Contracting & Provider Relations, couldn’t agree more. “Being a good listener is very important,” says Kendrick, who is Director of Provider Operations at CHOICE. “The job is all about being able to resolve the issue.” In addition to memorizing the script that’s provided to them, CHOICE call center reps also learn to think on their feet.  All the while, the rep documents the details of the call, focusing on remaining patient, calm and polite.

Tatiyana Adams, also a Provider Service Associate. For Call Center associates, careful listening is key.

Incentives also play an important part in the Call Center’s operations. There’s a wall in the center displaying the names of reps who score 100 percent on their performance reviews. Standout reps receive gift cards on a quarterly basis, and on occasion the center has hosted a pizza party for the associates. Every team member understands that, for providers, the Call Center is often the main interface they have with VNSNY CHOICE. “Even when it turns out a provider’s claim isn’t covered,” says Kendrick, “we still want them to go away knowing that our associates have tried their very best to help them.”

Robert Johnson, CHOICE Provider Service Associate. “How may I help you today?”

Providing consistently good service to CHOICE providers also impacts the experience of CHOICE plan members, notes Dr. Hany Abdelaal, President of CHOICE. “When our providers are pleased with the support we give them, it carries over into a positive response whenever our members reach out to them for care,” he says. “A satisfied provider helps to ensure a satisfied member—and our Provider Call Center plays a key role in making certain that happens.”