Health Plan, Version 6.0 P-MR 6-General Telephone Access


The Basics

This standard requires that your organization provide to consumers access to a toll-free line at least 40 hours per week.  That line must be open between 9 a.m. and 4 p.m. each business day in each time zone in your service area.  The only exceptions to that would be time zones in which you have fewer than 2% of your consumers.  Your organization no doubt has a policy and procedure that establishes the specific hours your organization's toll-free line is available.  Make sure you're familiar with it in addition to the standard.

Management Tips

Your communications plan should specify the hours of availability for your toll-free telephone line.  In addition, he should be able to produce documentation demonstrating what percentage of your consumers are in each time zone in your service area.  Furthermore, your communications to consumers should include your toll-free telephone line's hours of operations.  Be sure that your communications plan and those consumer communications agree with each other regarding those available times.

URAC Accreditation Tips

This standard is weighted 4.

For the desktop review, submit your vacations planned or P&Ps specifying your toll-free telephone line's available hours.  In addition, you should submit a sample of consumer communications that provide the hours of that line.

During the on-site review, the reviewer is likely not only to interview your customer service managers about the standard, but also to place "secret-shopper" calls to that number to make sure that you are implementing your policies and procedures.