Department of Civil Service

PA03-11

TO: Participating Agency Health Benefits Administrators
FROM: Employee Benefits Division
SUBJECT: New HBA Help Line
DATE: May 8, 2003

The Employee Benefits Division (EBD) is pleased to announce a consolidated phone line for Health Benefit Administrators from Participating Agencies and Participating Employers. The phone line is operational, so starting immediately, you will no longer have to play phone tag or listen to a constant busy signal when trying to reach EBD staff with questions on processing, claims, enrollment or eligibility.

The new HBA phone line number is:
518-457-2364

Calling this one phone number will connect you to the processing unit or to a program services representative, as well as providing Empire Plan carrier information. The new number will be staffed from 8:00 a.m. to 4:30 p.m. every business day. Please Note: this number is for Health Benefits Administrators only. Enrollees with questions on claims or eligibility decisions that you are unable to address should still be referred to the Employee Benefits Division at 1-800-833-4344. If you give this new HBA help line number out to enrollees, it will take us longer to get to your call.

When you call, the Avaya Conversant IVR (Interactive Voice Response) System will ask for your agency code – so please have it ready before you dial. Additionally, if you are calling about a particular enrollee, also be ready with the enrollee’s identification number. Having these two numbers ready when you call will allow us to assist you more expediently. Once you enter or say your agency code (and been identified as a Participating Agency) you will be offered a series of menu choices, designed to direct your call to the correct unit. Once your call is directed to the unit, you will wait “in queue” for the next available customer service representative. That’s right – no more busy signals!

Since this is a new concept for us in the PA unit, we are unable to estimate wait times at this time. As we collect statistics we will pass along information like the best time to call (and not to call). If in the beginning the wait times seem long, please be patient. You too will receive our undivided attention. Also, although our “old” numbers will still be functional – we strongly encourage everyone to use the new system. By calling through on the new phone number, 518-457-2364, we can track call statistics which will be very valuable in assigning resources within EBD.

After entering your agency code, you will hear the following choices. Choose the one that best fits the needs of your call:

Choose option (1) for the Processing unit to answer:
NYBEAS Processing questions
Questions on eligibility or enrollment rules
How to complete a PS-503.1 transaction form
To verify a new enrollment or enrollment change that was sent for processing
Any other reason you previously called the processing unit

Choose option (2) for questions on your bill or statement:
Note: while this option will currently connect you with the same bank of PA unit staff, using the separate option will help us track how many calls relate exclusively to billing. Calls for which the staff is unsure will be passed to our billing staff person. Based on need and usage, we may be able to staff this selection in the future with staff members specifically trained to answer your billing questions.

Choose option (3) for a Program Services unit Representative to answer:
General claims questions such as what carrier a claim is filed with or co-pay information
Specific information on preadmission requirements or certifications
Questions regarding how claims were paid (remember under HIPAA, we can not talk to the HBA about an enrollee claim without an authorization or a 3 way call)
Appeal procedures for denied claims
Special circumstances that need clarification on a NYSHIP eligibility rule.

Choose option (4) for Empire Plan Carrier Information:
Recorded information on how to contact Empire Plan Carriers and a brief description of what is handled by each carrier.
Remember – the Empire Plan carriers now have one consolidated number –1-877-769-7447

Our Primary goal for this upgraded phone system is to provide more efficient customer service to Health Benefits Administrators. Your assistance in calling the new system when appropriate will be greatly appreciated.

Remember – for all your Employee Benefits Division needs call:

518-457-2364

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