Procedures for Recording Contacts – Call Center

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Procedures for Recording Contacts – Call Center

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  1. It is not necessary to record a call in the Contacts Module if a client calls the Call Center, is screened and an appointment is set. The scheduling of the appointment and submission of the application will record the call contact.
  2. If a client calls for a reason such as problem with medical bill, complaint, etc., follow the instructions in that particular topic area for recording the call contact.
  3. If the call does not fall within the specific instructions for a topic area or a specific category, i.e. Pharmacy, Eligibility Information, Misdirected Calls, etc., record the call under “Customer Service Call Center, Request for Information/Issues, General Information”.
  4. If a call falls into 2 or more distinct topic areas, record the call contact under each of the applicable areas as per the instructions for that topic area.
  5. If, after scheduling an appointment you give the caller general information about the appointment or the program, there is no need to record a second contact. It is an expectation that when a client is helped, they will also be given general information about the process and programs.
  6. Below are examples that can help in selecting the correct topic area or category for the call:
  • Eligibility Information:
    • “What documents do I need to bring to my appointment?”
    • “What are the requirements for eligibility?”
  • Misdirected Call:
    • “Can I receive payment assistance with my electric bill?”
    • “I would like to apply for the Blue Card?”
  • Pharmacy:
    • “I am at my pharmacy, and they are telling me my card is not active?”
    • “My pharmacy needs additional information to fill my prescription.”
  • Complaints:
    • MAP Eligibility Staff Complaints
    • MAP Eligibility Call Center Complaints
    • CUC Eligibility Financial Screening Complaints
  • General Information:
    • “Can I please have directions to the South location?”
    • “What time does the Northeast office open?”
    • “I am unable to get a medical appointment.”
    • “I would like to submit a complaint.”
  • MAP Benefits-Patient:
    • “I am a MAP patient. What are my benefits?”
  • MAP Benefits-Provider:
    • “I am a provider, and I would like to inquire about MAP benefits.”
  • Screened Ineligible:
    • Use this category for clients that are screened ineligible for MAP, MAP Basic, Medicaid, or CHIP.
  • State Application Assistance:
    • Use this category for clients that are following up on an application we have submitted on their behalf.
  • Marketplace Application:
    • Use this contact for any escalated calls with issues regarding ACA/Marketplace/CHAP. Use this contact when client receives a Sendero IdealCare Invoice with an amount other than $0 and for clients requiring a call back regarding their Marketplace/CHAP application. Example: “I was referred to apply for the Marketplace and I was told I do not qualify for tax credits”.
  • Eligibility Update: 
    • Use this category for clients that have active MAP coverage. Ex. Client states they have moved out of the county, or have active Medicaid, or reports income over MAP limits.
  • Attestation Submitted:
    • Use this category after submitting a Telephone Attestation for Homeless
  • Outbound Calls:
    • Use this contact to record successful outbound calls such as CHAP, ACA, Appointment Reminder calls.
  • Marketplace Referral:
    • Use this contact when referring or scheduling a client an ACA appointment with a Marketplace assister.
Previous Eligibility Office Locations/Sites
Next Calls about Virtual and Mail-In MAP Applications
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