At ComplexCare Solutions, our employees and delegates have the experience, training and personal dedication to communicate clearly and compassionately with members, and to inspire action.
The licensed practitioners who conduct the assessments combine the qualities of a friendly confidant, health adviser, motivational speaker, and home inspector all in one. They know what to look for and listen for when performing assessments.
To help these licensed practitioners do the best job possible, we arm them with the latest technology for recording and analyzing data. By combining the right people and technology, we have developed proven models for engaging members and delivering the outcomes our health plan partners expect.
Data management and analytics tools
ComplexCare Solutions uses an innovative proprietary technology platform that collects and organizes a robust range of member information that we draw upon for effective engagement. Automated features enable consistent and cost-efficient outreach and reporting.
Tracking systems
All assessment and reassessment data recorded by ComplexCare Solutions is automatically fed into a program that reveals progress on clinical and financial outcomes for each member or population group.
Electronic health record
All assessment data is entered into our electronic health record that is shared by our call center staff and licensed practitioners. Prior to assessment, records are prepopulated with health plan data, including key information on pre-existing conditions, medications, allergies, social determinants, environmental conditions and other health history.
ComplexCare Solutions call center employees are trained on the specific plan’s process, procedures and mutually agreed-upon scripts. Our callers are experts at engaging members and follow all CMS and HIPAA criteria for privacy requirements and telephone handling procedures. We record 100% of both our outbound and inbound calls. Our call monitoring processes track a variety of quality, productivity and conversion metrics.
Capabilities and enhancements:
- A multilingual and multicultural staff available 24/7
- Autodialer
- IVR and ACD
- Recorded and documented member calls
- Member phone and address validation (weekly or monthly)
- Ability to enhance member contact information
- Ability to provide client-specific 1-800 numbers, including warm transfers to the client’s member services
- Ability to display phone number using the client’s name or CCS
- Ability to fully “white label” under client’s identity
- Ability to manage member-specific campaigns
