Clinical Call Center Operation and Management
Clinical Pharmacy Services provides clinical call center operation and management services for government, nonprofit, and commercial clients. We take pride in our excellent customer service. Our decisions are fast, accurate, and evidence-based.
To maintain our high performance, our managers routinely monitor the clinical call center. We assign metrics for a range of categories:
- Appropriate customer service interactions
- Quality of decisions
- Efficiency of call handling
- Time elapsed before call is answered
- Abandoned call rate
- Handling time per call
Continuously evaluating these individual areas enables us to maintain high-quality services and strengthen the functions of the call center as a whole.
MassHealth Call Center
Clinical Pharmacy Services has been providing clinical call center service for MassHealth, the Medicaid program in Massachusetts, since 1999. When MassHealth providers and pharmacists reach the clinical call center at Clinical Pharmacy Services, they immediately speak with a registered pharmacist with the knowledge and authority to respond to inquiries.
We receive requests, render decisions, and process prior authorizations via phone, fax, electronic submission, and mail:
- Waiting time is 11 seconds per call
- Handling time is 4 minutes per call
- 99.6 percent of prior authorization requests are reviewed within 24 hours of receipt, 365 days a year
- Abandoned call rate = 1.7%
- Monthly prior authorization volume = 7,500 (up from 7,000)
While speed is essential when handling nearly 8,000 general calls and 7,000 prior authorization requests for MassHealth each month, our staff is dedicated to providing high-quality customer service and appropriate responses to each and every caller.
The registered pharmacists staffing our call center provide resources for providers and pharmacists working with MassHealth members. Those with questions about prior authorization requirements or drug requests rejected at the pharmacy counter can always reach us.