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2025-125
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2025-125
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Last modified
6/23/2025 10:25:09 AM
Creation date
6/23/2025 10:16:29 AM
Metadata
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Template:
Official Documents
Official Document Type
Amendment
Approved Date
06/03/2025
Control Number
2025-125
Agenda Item Number
13.D.1.
Entity Name
Blue Cross and Blue Shield of Florida, Inc.
Subject
Amendment No. 1 to Administrative Services Agreement
Document Relationships
2025-126
(Cover Page)
Path:
\Official Documents\2020's\2025
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A TRUE COPY <br />CERTIFICATION ON LAST PAGE <br />`;'N L. BUTLER, CLERK <br />EXHIBIT D <br />Performance Guarantees <br />Indian River Board of County Commissioners <br />Guarantees are based on book of business results. <br />Number of calls that reach the call center and are placed in <br />55% <br />0% <br />queue but do not reach the final destination because the caller <br />z5.1 % <br />1 % <br />hangs up before a representative becomes available. <br />Average ACD Phone Queue Time <br />Actual length of time a member waits to speak with a customer <br />530 seconds <br />0% <br />service associate after all ACD options have been chosen. <br />- <br />z31 seconds <br />1% <br />Blockage Rate <br />58% <br />0% <br />Percentage of calls blocked during business hours. <br />z8.1 % <br />1% <br />i <br />Enrollment Timeliness <br />1 <br />Percentage of ID cards mailed by effective date provided that <br />z99% <br />0% <br />the enrollment data is received from the employer 30 days prior <br />598.9% <br />1 % <br />to the effective date of coverage. <br />Claims Processing Timeliness <br />Percentage of provider and subscriber claims processed within <br />30 calendar days from receipt to the date that a claim has <br />Zg7% <br />0% <br />passed all edits and is pending the issuance of a check, <br />:596.9% <br />1 % <br />voucher or denial. <br />Claims Processing Accuracy <br />z97% <br />0% <br />Percentage of claims processed accurately. <br />596.9% <br />1% <br />Claims Dollar Accuracy <br />Z98% <br />0% <br />Percentage of claim dollars paid accurately. <br />597.9% <br />1% <br />Inquiry Timeliness <br />- <br />1 <br />Percentage of inquiries finalize within 7 days <br /><90% <br />% <br />26 <br />
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