What is my deductible? Can someone explain the bill I received? Do I have coverage for an eye exam? Whether you’re a longtime member of Harvard Pilgrim or recently selected one of our health plans, it’s natural for questions to arise as you utilize your health insurance. And while we have digital resources with specific plan information available through our member portal, sometimes it can be beneficial to speak with someone directly.
That’s where the Harvard Pilgrim Health Care member services team comes in. A wealth of knowledge, member services is available to answer any questions you may have about your health plan. To learn more about member services, we connected with Cary Mulcahy, who has worked as a member services representative for over 20 years.
Here’s what Cary had to share about his role and working with our members:
The role of a member services representative
88% reported Harvard Pilgrim made it easy to get their question answered or problem resolved*
On average, Cary fields about 50 to 70 calls each day. Some calls are from other colleagues with questions on specifics with our plan offerings, though most are from members who have questions about their coverage. Some conversations are brief, only taking a couple of minutes to answer a quick inquiry, while others could last 30 minutes to an hour if a member wants to talk through multiple topics. While Cary can expect that a typical day will include plenty of conversations, it’s always a surprise as to what he’s going to get a call about—something that he says helps to keep the team on their toes.
No matter the question, Cary provides an answer or connects a member to a helpful resource. He’s also available to respond to questions that are emailed through Harvard Pilgrim’s secure online portal. Questions members have can range from anything on ID cards or fitness reimbursements to billing or coverage.
For more specific questions from members, there are times where Cary will need to connect with team members from other departments to do a little digging. He often speaks with internal pharmacists and colleagues from the finance and benefits departments to find the answers he’s looking for. Sometimes he’ll even get a call from a nurse care manager with a member directly on the line.
Helping members near and far
While many of Cary’s callers often have quick questions, there are times when members need more assistance. He recounts a call he received from a member after a having a heart attack while out of the country. A scary time for the member, who was still abroad when calling, Cary worked with him over the course of a few days. He not only helped with paperwork that needed to be processed for the member’s reimbursement but helped to ensure the member had what he needed to be able to fly home after his hospital stay.
While evident from the last anecdote, one takeaway Cary shared is just how much the member services team cares about helping members.
“We care about our members; we really do care deeply about them and want them to have the best care they can.”
Get in touch with member services
If you’re a member that has a question about your Harvard Pilgrim health plan, contact member services at (888)-333-4742 or by sending a secure email. And for plan details and other member resources, log in to the member portal.
*Source: Data compiled from Harvard Pilgrim Voice of the Customer program (2021)