- Sampling of Retiree Services Provided – Personal information changes; Card replacements; Formulary, tier and copay assistance and exceptions; Physician and pharmacy outreach; Inbound/Outbound three-ways calls to Medicare, vendors, providers, pharmacies, and Social Security; Claims, billing and payment support; Help with filing of applications, including Low-Income Premium Subsidy (LIPS) filing assistance; Assistance with pharmacy related questions such as generic availability, prior authorizations and mail-order services; Status calls throughout the process of any open item, making sure members know their problem is of highest concern and we are working on a resolution; Completion calls to member after any issue has been resolved to ensure no additional assistance is needed
- Retiree Service Center – toll-free call center access; Customer service team members fully trained in Medicare products and updates to regulations; Locate a pharmacy; Access your Explanation of Benefits; Access to general benefit details; All content can be viewed with screen readers for sight-impaired members; Availability to view content in Spanish
- Eligibility Management – Coordinate all applicable eligibility and enrollment information with the carriers and provide eligibility management services
- Dedicated Client Account Management Team
- Enrollment Type Options – Group Enrollment with Opt-In/Opt-Out Capabilities; Voluntary Enrollment (Face-to-face, Online, Telephonic, Mail & Fax); Member Mailings: Craft and fulfill client’s customized announcement letters, pre-enrollment kits and welcome kits; Communication pieces custom crafted for retirees to easily understand while adhering to CMS compliance requirements
- Meetings – Educational, Plan Kick-off, Enrollment, ongoing retiree Group, and Wellness Initiative Meetings
- Eligibility Scrubbing – Manage all eligibility maintenance in CMS’s approved format, so the client does not need to change their business process; Age-In and Dis-Enrollments; Customized enrollment and dis-enrollment process to meet client’s needs
- Member Advocacy Center – Proprietary phone and software system; Customized greetings and client phone numbers; No dial-by directories, our advocates answer every call; 100% domestic with over 300 languages available. TTY compatible; All calls are recorded and stored for 10 years
- Billing Capabilities – Direct Client – Group list billing; Split billing (Client/Member); Member Direct Bill (100% Member through ACH); Integrated HRA; LEP & LIS billing available
- Reporting – Member Interaction Reports; Customized call Transcriptions Reports; Utilization Reporting; Customized ad-hoc reporting; Plan Document Review
- Our Retiree Advocates are AHIP Certified; Life and Health Insurance Licensed; HIPAA Compliant; Attend Specialized Geriatric Training
If you have any questions regarding our services or would like more information, please contact Nicole Allen at nallen@ktpadvisors.com.