For the average person, almost anything related to health insurance is complex and overwhelming. Therefore, when problems occur—as they often do—people feel frustrated. However, employees whose health insurance benefits are brokered by Creative Benefits enjoy a very special benefit—instant access to the Employee Services Representative (ESR) Team.
The ESR Team is a group of benefits specialists who help employees of companies whose group benefits are administered by Creative Benefits to solve insurance issues. Our ESR Team members are former insurance account managers with five to 25 years of industry experience. We know our way around the maze of regulations and details that characterize the medical insurance marketplace.
No problem is too large or too small for the ESR Team. One caller may need an ID card or another just the verification of an ID number. A member might be standing in the pharmacy unable to get their medicine because their doctor did not authorize a refill or because they are not showing up as active under the group plan. Often, employees call when claims have been denied or there are problems with billing or coding. No matter what crops up, our team takes care of it.
With the ESR Team on their side, employees are relieved of the hassle of following up with insurance companies, providers and/or billing offices. Members do not have time or patience to spend hours trying to figure out how to solve problems they do not understand. Knowing they have the expertise of an ESR Team member is a big relief. Members feel good when someone is fighting for them.
The ESR Team is anything but a typical call center. We stay involved until it is clear a resolution to an issue is found. If a claim is to be reprocessed, we reconnect with employees/providers to ensure all necessary documents are resubmitted. We routinely coordinate both verbal and written appeals on behalf of members. We call insurers to confirm that Explanation of Benefits have been sent, and everything is documented so follow up is handled properly and promptly. When members understand all that the ESR team does to help, their burdens are lifted.
Health insurance issues are upsetting and making sure people feel better at the end of the call than they did at the beginning is crucial. For the ESR Team, everyone on the other side of a call or e-mail is an individual. We believe in treating others as we would like to be treated. It is frustrating when someone calls a help line only to end up getting answers that sound like a canned script. The ESR Team never uses clichéd answers.
When people receive good service, it makes for a much better day. This reflects positively on employers and may even help employee retention. The ESR Team also addresses the needs of respective group HR personnel. Concerns of HR staff range from monthly billing reconciliation, guidance on pre-certification, and more. With assistance from the ESR Team, HR personnel can have more quality time for internal employee relations, and waste less time waiting on hold on the phone.
People are often surprised to learn about the ESR Team and discover that the services we offer are included at no extra charge for any company partnering with Creative Benefits. Few companies have customer service that can compare. The years of experience in the insurance marketplace and expertise in the insurance field are very important, but what really sets us apart are the personal qualities of each team member. Dedication and caring for people is what elevates customer service at Creative Benefits from good to great.