When members have a question or challenge with their Medicaid renewal, states provide multiple options to get support. These include in-person support at local eligibility offices, over-the-phone support, and support from Navigators. However, not all members experience the same level of support.
It’s not always clear to members what support options are available. When searching online for help renewing Medicaid, official state websites don’t always rank towards the top. Furthermore, not all members are familiar with Navigators or aware that individualized support is avaialbe to help them through the renewal process.
With the public health emergency ending, members need to take action to renew their Medicaid for the first time in several years. Some members are renewing for the first time. Navigators report that the return to annual renewals has resulted in fear, confusion, and questions among members. More members are reaching out for support than any time in the past few years.
During the public health emergency, annual renewals paused. This meant less work for eligibility worker staff and call center agents. As such, many states downsized staff during this time. After the public health emergency ended, states struggled to fill vacant seats across call centers and eligibility staff. Many states report continued staffing shortages and high attrition rates, as well as an influx of new hires with minimal experience in their state’s Medicaid policies and programs.
Members and Navigators report having to call in or go in person to an eligibility office multiple times to try to speak with someone who can help them. It’s a roll of the dice on who will pick up the phone, or who will get assigned to your case. Sometimes members are connected to a tenured eligibility worker. Other times, they are connected to a new hire who is unfamiliar with their state’s Medicaid policies and programs.
When a member or Navigator is assigned an agent or eligibility worker who is unable to resolve their issue, it sometimes results in a dead end. Members and Navigators report that there is not always the option to speak to a manager or supervisor to resolve an issue. Navigators in some states fall back to a formal appeals process when they cannot resolve an issue otherwise.
Put your renewer hat on and try to find out where to get help on a particular Medicaid renewal topic in your state. Document the experience as you go, capturing screenshots and notes. Mark areas of confusion or frustration.
Review escalation paths to ensure members can efficiently get routed to someone who can resolve their issue when an entry-level eligibility worker or agent can’t help.
Call center wait times across the nation are high for help with Medicaid renewals. However, some counties reported experiencing more burden than others. Those living in a high-density urban areas are typically met with longer wait times than those living in rural areas.
In some states, the option to renew over the phone is not an available option in the state’s interactive voice response (IVR) menu. In some states, language options that are available in the are not actually hooked up to a representative who speaks that language.
Many states use Language Line for translations when bilingual agents are not available. However, this results in additional wait time for members with limited English proficiency. Through the use of an interpreter as in Language Line, context is missed and key details get lost in translation.
Call in to the customer support line as a renewer and document your experience. Note areas of confusion or frustration, record your wait time, take notes on the IVR, and highlight areas for opportunity.
Ask for average wait times, average call times, containment rates, and issue resolution rates across the state. Compare state baseline data to data across regions (e.g. urban vs rural counties) and populations (e.g. English vs non-English speakers) to identify challenges across the customer support experience.
Review Interactive Voice Response (IVR) menus to ensure callers can easily and efficiently get routed to an agent who can answer their questions and resolve their issues. Ensure top caller questions are reflected in IVR menus (e.g. “Renewing” should be included).
When callers are transferred to another department, ensure they keep their spot in line and don’t go to the back of line in a second queue.
Review escalation paths to ensure callers can efficiently get routed to someone who can resolve their issue when an entry-level eligibility worker or agent can’t help.
In some states, language options that are available in the are not actually hooked up to a representative who speaks that language.