As part of our commitment to provider connection, AmeriHealth has held provider engagement forums at our Center City Philadelphia campus on a variety of topics including communications, demographics, and the provider network service experience.

Hundreds of attendees, representing a cross-section of network providers and billing agencies, have taken part in our Provider Engagement Forums since they began last year. We are pleased to share the changes we’ve implemented based on feedback from the providers who attended our spring session on the provider network service experience.

You spoke, we listened

We collected providers’ feedback at each session this spring, collated it, and identified several common themes. We then determined key areas of focus for immediate action and others to research and develop long-term plans for improvement.

• Wait time. We have added capability to deploy a front-end message to make the caller aware of anticipated wait times. If the hold times in the queues for claims, benefits, and eligibility are longer than expected, the caller will hear a message with an approximate wait time.
• Claims training. The team is assessing knowledge gaps and developing action plans for additional claims training for call center representatives.
• Surveys. We will send out quick email surveys on a periodic basis to our network to maintain a pulse on your overall experience and to obtain feedback as we implement enhancements – your response is important!
• Self-service requirements. We’re revisiting our self-service requirements and associated workflow and will implement retraining of call center representatives.

• Quality. We will be enhancing quality review of claim investigation responses to improve response language.
• Support. We will implement enhanced support for claim investigations requiring further review.

• Staff. We are in the process of adding and training new staff to assist with handling provider issues in a timely manner.
• Workflow. We are assessing current workflows within our provider relations team to mitigate process gaps and ensure work is routed appropriately for handling. 
• Follow-ups. We are reviewing follow-up procedures to ensure providers receive periodic status updates for all outstanding issues.

We hope that these measures result in a better experience for you, our providers.