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24 hours a day 7 days a week

Live Phone Representatives are available:
Monday-Friday,
9:00 am to 5:00 pm
1-888-801-1660

New York Claims Submission Address:
P.O Box 958438
Lake Mary, FL 32795

New York Request for Review and Reconsideration:
P.O Box 958438
Lake Mary, FL 32795

Electronic Payor ID: 80141

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Improving Member Satisfaction

Improving Members Experience of Care

At Healthfirst, it is part of our mission to provide members with a superior experience of care. Below you will find the areas providers should focus on for improving, some best practices for improvement, and links to helpful resources.  

Areas of focus:

  • Getting appointments with primary care doctors and specialists easily
  • Providing appointments within 4 weeks of requested date
  • Keeping phone numbers for requesting appointments up to date
  • Having phone answered at all times during business hours
  • Having an answering service or message which directs members 24 hours a day
  • Providing care as soon as a member needs it
  • Keeping wait time within 15 minutes of appointment time
  • Using medical records and other information about the member’s care
  • Following up with the member to provide test results and explaining test results clearly
  • Getting member test results quickly
  • Speaking to the member about prescription medicines that member is taking
  • Helping members manage care across the delivery system
  • Staying informed and up-to-date about members Specialist care
  • Involving member in decisions regarding tests and treatment

Best Practices by Providers for Improving Member Experience of Care:

Healthfirst conducts regular satisfaction surveys throughout the year to gather feedback directly from our members. The following list identifies best practices as outlined by high performing providers. We encourage providers to review and integrate these practices to help enhance the member experience of care.

  • Periodically conduct member satisfaction surveys for your Healthfirst members throughout the year to identify their concerns
  • Schedule appointments with new Healthfirst members and members with gaps in care such as those listed on the members missing services list
  • Give appointment reminders prior to a member’s scheduled visit
  • Be mindful of the time you spend with each member. This includes listening to member concerns and thoroughly answering questions in a way that is easily understandable – in plain language, with simple directions
  • Follow up with members who have missed appointments and try to reschedule
  • Educate staff on the benefits of meaningful use of electronic health records to improve health care
  • Provide members with a written visit summary sheet at the end of their visit, documenting the reason for the visit, what was discussed, any next steps and a treatment plan outline
  • Provide timely outreach to members after an Emergency Room visit or hospital stay
  • Track referrals for high risk members and facilitate appointments with Specialists for needed treatment and exams
  • Ensure that there is member care coordination within the practice and across the delivery system
  • Have feedback forms available so that members may comment on the service they received after their visit

Useful Resources

Review Healthfirst’s Appointment Availability and 24-Hour Access Standards (see section 3.4 of the Provider Manual).

Review the expectations and responsibilities of providers with respect to providing high-quality services to our members (see sections 3.1 and 3.2 of the Provider Manual).

 

Last update 2014-03-28 13:37