Customer Service
Achieve client satisfaction of at least 90%
Achieve participant satisfaction of at least 85%
Achieve provider satisfaction of at least 80%
Maintain average hold time of less than 60 seconds
and abandon rate of 5% or less
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Quality AssuranceFox-Everett maintains a quality assurance program for Claims, Customer Service and Enrollment featuring the following:
Comprehensive QA on transactions processed by
new employees
Random QA of day-to-day transactions performed in
claims office
Detailed review of 100% of adjustments and appeal
"reversals" to determine if those transactions
resulted from procedural or financial errors
"Focused" QA programs related to new clients
and/or specific benefits/plans
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Subrogation AdministrationFox-Everett focuses on early intervention to achieve recovery success for our clients on claims that are the responsibility of a third party.
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Eligibility and Billing AdministrationFox-Everett performs eligibility and premium administration for our self-funded clients including monthly billing statements and eligibility listings. Our eligibility system tracks all date sensitive changes in eligibility and coverage and is integrated with claim processing.
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COBRA Coverage Continuation AdministrationFox-Everett offers complete COBRA administration services. These services include:
Providing initial COBRA notices to all covered
employees and spouses
Generate notice of COBRA continuation right
to terminated participants within 5 working days of
date termination is processed
Process ongoing COBRA premium payments and
return premium to Plan Sponsor
Notify COBRA beneficiary of termination of COBRA
coverage and provide HIPAA certificate
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