Our Centralized Engagement Team – Quality Customer Service when you need it!
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The Centralized Engagement Center (CEC) handles approximately 50,000 inbound calls per month. Our team works hand-in-hand to support our main priorities – our providers and members. The CEC is made up of four teams:
(Available Monday – Friday, 8:30 a.m. – 5:30 p.m.)
- Handle inquiries on authorizations/claims/ eligibility
- Educate/assist callers on navigation of HCP protocols
- Aid with demographic updates/corrections
- Fulfill requests for copies of explanation of benefits
- Help modify existing referrals
- Search for participating providers
PAL Team – Available 24/7
- Direct callers to appropriate Clinical Services/Medical Management resources
- Schedule appointments
- Conduct member outreach calls
- Expedite urgent referral calls
- Handle post ER discharge follow-up calls
- Connect physicians on peer-to-peer calls
Customer Resolution Specialists
- Resolve escalated provider claim, authorization, referral, & eligibility issues
- Provide EZ-Net & provider portal support & guidance
- Respond to member and provider email inquiries
- Connect inbound callers from our corporate telephone number with the appropriate HCP associate or department
Not sure who to call? Start with Customer Service and we will direct you.