Fiscal Employer Agent (Fea): Customer Service

01. Customer Service System. The provider must provide a customer service system to respond to al l inquiries from participants, employees, agencies, and vendors. The provider must: (3-17-22) a. Provide staff with customer service training with an emphasis on consumer-direction. (3-17-22) b. Ensure staff are trained and have the skills to assist participants with enrollment and to help the m understand their account statements. (3-17-22) c. Ensure that FEA personnel are available during regular business hours. (7-1-25) d. Provide translation and interpreter services. (7-1-25) e. Provide prompt and consistent response to verbal and written communication. Specifically: (3-17-22) i. All calls and voice mails must be responded to within one (1) business day; and (7-1-24) ii. All written and electronic correspondence must be responded to within five (5) business days. (3-17-22) f. Maintain a toll-free phone line where callers speak to a live person during business hours and ar e provided the option to leave voice mail at any time. (7-1-25) g. Maintain a toll-free fax line that is available at any time, exclusively for participants and thei r employees. (7-1-25) h. Maintain an e-mail address. (7-1-25) 02. Complaint Resolution and Tracking System. The provider is responsible for receiving , responding to, and tracking all complaints from any source under this agreement and corrective actions. A complain t is defined as a verbal or written expression of dissatisfaction about FEA services. The provider must: (7-1-25) a. Respond to all written and electronic correspondence within five business (5) days. (7-1-24) b. Respond to all calls and voicemails within one (1) business day. (7-1-24) c. Maintain an electronic tracking system and log of complaints and resolutions accessible fo r Department review through the SFTP site. (7-1-25) d. Log and track complaints received from the Department pertaining to FEA services. (7-1-25) e. Compile a quarterly summary report analyzing complaints to determine the quality of services t o participants and to identify any corrective action necessary. (7-1-25) f. Implement corrective action within one (1) business day of the complaint response. (7-1-25) g. Post the complaint to the SFTP site within one (1) business day. Failure to comply will result in a fifty dollar ($50) penalty payable to Medicaid within ninety (90) days of incident. (7-1-25)