Performance Data

The Centers for Medicare & Medicaid Services (CMS) administers and oversees the Provider Customer Service Program (PCSP) at the Medicare Administrative Contractors (MACs). CMS analyzes data to identify trends and make recommendations to improve the performance of the Medicare Fee-for-Service provider contact centers, the provider self-service technology options and to increase provider satisfaction.   

Key performance measures for the previous 3 months are available below so MACs can measure their performance against the national data. 

Provider Customer Service Program (PCSP): March 2022  – May 2022


Contact Center

Metric March 2022 April 2022 May 2022

Average Speed of Answer (Seconds)

53.7 37.9 36.3
Average Talk Time (Minutes) 6.9 6.7 6.7
Completion Rate 98.9% 98.9% 98.9%
IVR Handle Rate 42.7% 41.6% 41.9%
IVR Transactions 1,381,789 1,217,928 1,224,615
Written Correspondence Received 32,175 26,086 29,074
Portal Transactions Received 22,317,487 20,429,388 20,429,422


Provider Outreach and Education (POE)

Metric March 2022 April 2022 May 2022
POE Events 542 563 584
POE Events (Attendees) 18,555 25,418 30,460
Self-Paced Education (Occurrences) 1,810 1,801 1,843
Self-Paced Education (Clicks) 897,478 818,343 763,999


Quality
 

Metric March 2022 April 2022 May 2022
Quality Assurance Monitoring (QAM) 96% 99% 98%
QCM (Privacy Act) 98% 98% 97%
QCM (Knowledge Skills) 95% 95% 95%
QCM (Customer Skills) 99% 99% 99%
QWCM (Privacy Act) 99% 100% 99%
QWCM (Knowledge Skills) 98% 99% 99%
QWCM (Customer Skills) 100% 100% 100%

 



Telecom Performance (March 2022 - May 2022)

Call Completions, CSR Answered Calls, and IVR Handled Calls charted for three months.

Monthly Completion Rates shown at bottom of graph - 99.1%, 97.7%, 98.9%

 

 

Provider Inquiries (March 2022 - May 2022)

Top 5 Subcategories - Telephone Inquiries 

Claim Denials	Claim Overlap	91,929
Claim Status	Payment Explanation/Calculation	88,621
Claim Denials	Coding Errors/Modifiers	78,639
Claim Denials	Contractual Obligation Not Met	74,106
RTP/Unprocessable Claim	Contractual Obligation Not Met	67,012

Total CSR Telephone Inquiries: 1,425,110

 


Top 5 Subcategories - Written Inquiries

Appeals	Duplicates	26,114
RTP/Unprocessable Claim	Contractual Obligation Not Met	13,337
Appeals	Explanation/Resolution	10,593
Administrative Billing Issues	Filing/Billing Instructions	8,860
General Information	Incomplete Information Provided	8,840

Total Written Inquiries:  101,127

Each CSR call or written correspondence may cover one or more inquiries.

 

 

Provider Outreach and Education (March 2022 - May 2022)

Top 5 POE Subtopics

Claim Submission/Billing Items/Issues	
New Medicare Card	
582
Payment Items/Issues	
Claim Related Data Analyses and Reports (MR denials, CSEs, inquiries, CERT denials, CBRs, PEPPER)	
317
Claim Submission/Billing Items/Issues	
Filing/Billing Instructions/Strategies - (i.e., Special Billing, Timely Filing)	
309
Self Service Tools	
WebPortal	
264
Policy/ Coverage Rules	
Benefits/Exclusions/Coverage Criteria/Rules 	
220

Total POE Events:  1,689

Each event may cover one or more subtopics.

 

Page Last Modified:
06/15/2022 02:01 PM