Managing call volume remains a priority. As we continue to improve systems and procedures, our targeted call handling time is to answer 45% of calls in 30 seconds or less. Our target for email is to respond within 24 hours. Our highest call volume is experienced early in the week (Mondays - Wednesdays). The phone volume generally slows down at the end of the week. Based on telephone statistics, the best days to call to reduce waiting time are Thursday or Friday, 8:05 a.m. - 7:30 p.m. ET.
The telephone center has nearly tripled the number of staff over the last three years in order to meet and exceed our customers expectations. We have also added three experts in the field of call center/contact center operations, quality improvement, and technology to help foster improved and expanded ways to better serve all of our customers.
Early in 2003, we enhanced our Quality Improvement Program to help our customer service representatives provide our beneficiaries, sponsors and providers with the highest level of quality services possible. Our telephone customer satisfaction survey results indicate that we are consistently satisfying our customers greater than 95 percent of the time. You may ask the customer service representative to take the automated survey via the phone. In the future, the survey will be offered automatically, giving you a choice to take it without having to ask.
As this new year begins, remember that the annual (calendar year) outpatient deductible is reset. The deductible is $50.00 per beneficiary or $100.00 per family for the calendar year. Therefore, any claims with a Date of Service (DOS) after January 1st will have a deductible applied until the threshold is met.
The catastrophic cap of $3,000 per each CHAMPVA eligible family starts over with the new calendar year as well. CHAMPVA automatically calculates all of your cost shares and credits them to your Catastrophic Cap. When this reaches $3,000 for the family, CHAMPVA will then pay claims at 100%. Each calendar year, you are responsible for your 25% cost share until this cap is met. Be sure to check your explanation of benefits (EOB)s for accuracy.
CHAMPVA eligibility for a child after their 18th birthday is dependent upon them being a full time student. Verification of full time student status is accomplished through a School Certification. School Certifications must be on school letterhead, be signed by a school official and must contain the following information: student’s full name and SSN, the exact beginning and ending date for the semester or enrollment term, the number of semester hours or equivalent and must state that the student is enrolled full time. Because of the impact on eligibility and to avoid interruption of CHAMPVA medical coverage we encourage the submission of these certifications upon enrollment for each new semester.
We remain focused on our Center’s Mission and Vision of
being the VA experts in health plan management and efficiently
administering health plans. Our values of integrity, accountability,
trust, challenge, customer service and humor allow us to assist
in improving the quality of life for families of service connected,
permanently and totally disabled veterans and veterans deceased
related to a service-connected condition, or who died on active
duty and who are not otherwise eligible for DoD TRICARE benefits,
while honoring their sacrifices. We look forward to continuing
our working relationship with you and meeting the challenges ahead.