NorthCare Behavioral Health



REVISIONS TO POLICY STATEMENT: YES NO OTHER REVISIONS: YES NO

APPLIES TO:

All individuals requesting services from Northpointe

POLICY:

Customer Services (CS) encompasses rapid, accurate, linguistically understandable and culturally competent services to members and their families. NBHS will follow the Customer Service policy set forth by NorthCare Network .

PURPOSE: To ensure that all services enhance the relationship between the service recipient and the provider.

PROCEDURES:

The customer services operation is clearly identified at Northpointe and facilitates the following:

Phone access by the community and service recipients is available throughout normal business hours. The Access System is expected to be available, accessible and welcoming to all individuals on a telephone and a walk-in basis. All Michigan residents are assisted when contacting the access system. Individuals calling for mental health services or supports will be provided timely and welcoming access to eligibility screening.

1. Persons contacting the customer services operation speak with a staff member who has up-to-date knowledge regarding benefits, the provider network, Northpointe and network policies and procedures regarding access, transportation concerns, service authorization, and grievance/appeal procedures, recipient rights protection processes, and are skilled in customer relations. Access and Continuum appointments will be tracked by NBHS Medical Records and/or NorthCare Access staff.

2. A QI process whereby services or process improvement suggestions from individuals are routed in a timely manner to the appropriate part of the operation. This includes tracking and reporting patterns of problems or complaints for the organization.

3. Integration of individuals and family members into customer services operations including orienting new individuals and their families, creating special project work groups and councils, community awareness outreach initiatives, providing or facilitating arrangements for advocacy when requested, mentoring, developing information material, and customer satisfaction inquiries.

4. Special communication/limited English proficiency needs will be addressed.

5. Ongoing interactions through scheduling, billing, and coordinating with NorthCare Access, Medical Records and Clinical staff.

6. CS will maintain a suggestion box located at each NBHS site. Information gathered will be reviewed by the QI Dept.

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