Monitoring and Compliance

We use knowledge-based software to create, store, and retrieve information unique to each of our clients. This ensures that our customer service representatives have a full picture of your organization — and appear to be part of it in the eyes of your members and patients. Our goal is for your clients to think they’re talking directly to you, with each and every call.

We use a searchable dictionary, customized to your organization, to provide your clients with consistent information. When we update the system with your policy changes and other new information, it becomes instantly available to the customer service representatives.

With a wealth of data at their fingertips, our customer service representatives can accurately provide your clients with the help they need on issues such as

  • Policies and procedures
  • Coverage and eligibility requirements
  • Providers’ scheduling practices
  • Program-specific content

In addition, we track, analyze, and record calls via audio and video to provide clients with the following:

  • All original data
  • The date of each call attempt
  • The final outcome for each record
  • Follow-up needed (if applicable)
  • Barrier noted (if a barrier to obtaining the medication was mentioned)

UHealthSolutions analyzes report data on a regular basis in order to identify trends in call completion rates. Based on this analysis, call attempts are scheduled in a manner that will optimize the member contact rate.