2010-06-07_(2).pdf - 19318.8K - BridgeportCT.gov

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CIGNA HealthCare Performance Guarantee Agreement
Customer Bridgeport City BOE
Effective Date July 1 2010
Account Number s involved in Performance Guarantee s 3213172
IIr
CIGNA
Member Satisfaction
EmM
Risk
CIGNA will offer to conduct a first year benchmark member satisfaction survey We will not put dollars at risk for the first year For the
second year we will guarantee a percentage of improvement above thebenchmark Baseline
up to 85 based on the second year survey results with
dollars at risk There is an annual fee for Y N
conducting the survey of approximately 14 000 Account Management must initiate the survey
Results measured at Account Level
F ees eaRr at ISkO
Provider Recruitment
Fees At
Number of providers CIGNA attempts to recruit the criteria for provider eligibility and the recruitment proceSB will be determined by the
Network team 5 102 00
Risk
Network AccesslProvider Availabilitv
PCPswith closed practices less than 5 of PCPswith a closed practice
Network ChanleNotification
Notification will be made to client 30 days in advanceof termination date for hospitals and medical groups with more than 50 providers Sales
Team will be responsIble for momtonng Speed Reads and notifymg chent oftermmatlOns Results measured at Account Level
EmM
Risk
5 102 00
Fees At
Risk
5 102 00
Reports Delivered on Time
Deliver standard reports within 45 days of end of reporting period Results measured at Account Level
Reports Delivered on Time U
Deliver annual reports and regulatory documentation within90 days of policy year Results measured at Account Level
Fees At
Risk
5 102 00
Fees At
Risk
5 102 00
Imolementation
Implementation Satisfaction Score of no less than three 3 on Statement I
measured at Account Level
Fees At
Risk
of the CIGNA HealthCare Implementation Survey Results
29 000 00
Implementation ID Card Timeliness 98
Calendar Results measured at Account Level
of the ID cards will be mailed by the agreed upon commitment date in the Implementation
5 102 00
Implementation Claim Readiness Benefit Profile and eligibility information loaded on claims processing system as of the Commitment Date
set forth inthe approved Implementation Calendar Results measured at Account Level
5 102 00
Implementation Call Readiness Service Center s ready to respond to customer inquiries as of theCommitment Date set forth inthe approved
Implementation Calendar Results measured at Account Level
5 102 00
Abandonment
Fees At
Risk
Medical Call Abandonment Rate Measured for the Term of the Agreement results will not exceed 5 of calls received by Call Center s
terminated Results measured at Account Level 5 102 00
ASA
Fees At
Risk
Medical ASA Measured for the Tenn of the Agreement results will not exceed 30 seconds to answer a phone call Results measured at
Special Account Queue 5 I02 00
First Call Resolution
Medical First Call Resolution 90
of calls resolved on first call 45 day look backforward Results measured at Account Level
Fees At
Risk
5 102 00
Discount
One Way Medical Discount Guarantee SeeExhibit B fordetails
OS 28 2010
2010 Performance Guarantee Page 4