Customer Service is not just a department...It's Our Culture!

TML IEBP develops and maintains highly motivated staff, which are knowledgeable, solutions orients and understand the operations and workforce of the political subdivisions whom TML IEBP serves.
The Pool will strive to anticipate and to respond to the unique needs of the Members and plan participants through personalized, courteous and friendly services.

Quality Assurance
TML IEBP systematically reviews the quality of data entry, claims administration, billing & eligibility, New Member set up, customer service, outreach specialists, professional health coaching, medical management and plan design and management. Quality Management staff conduct audits of 5% of claims processed, and eligibility entry, 2% of customer service, and 100% of plan design and management with new member set-up. TML IEBP's standard for claims is 95% procedural accuracy and 99% financial accuracy.

Customer Service Team TML IEBP's customer service team strives to assist the covered individual in understanding their healthcare plan. The customer service staff provides friendly bilingual benefit information and educates covered individuals regarding medical and prescription benefit plans, benefit plan exclusions, limitations, notification requirements, out of pocket expenses, notification penalties, the appeal process, network variations, and Explanation of Benefits (EOB) information. Customer service options are customer service calls, customer service e-mail, and phone/fax information technology. Outreach to the Health Engagement population is provided by the Customer Service Team.

Your Membership Information is Protected Protecting the privacy and confidentiality of your personal information is a priority for TML IEBP. We are committed to maintaining the highest level of security for your personal information, including any information received from the myTML IEBP web portal. To achieve this, TML IEBP has adopted and adheres to security standards designed to protect your information against accidental or unauthorized access or disclosure. TML IEBP has implemented appropriate security measures to protect your information against loss, misuse or alteration. Among the safeguards that TML IEBP developed for this website are administrative, physical and technical barriers that, together, protect any information stored on myTML IEBP.

Service Standards

Customer Service

1. Call abandonment rate to meet/not exceed the industry standard of 5%
2. Calls in queue should be answered in 60 seconds or less
3. 95% accuracy on calls
4. 90% of calls closed on initial call

1. 90% paid in 14 calendar days
2. 95% paid in 21 calendar days
3. No claim over 30 calendar days old if all information to process is received or available within TML IEBP
4. No claim over 60 days old
5. 99% Financial accuracy (Paid)
6. 97% Procedural accuracy
7. 97% Payment accuracy
8. Implement Prompt Pay Policy and Procedure
9. Administer pre-existing procedure more effectively

1. 95% accuracy

1. 95% accuracy

1. Assessment of claims dollars per benefit category
2. Inpatient and Outpatient cost per day need calculation

1. Council Education/Consultative Services/Pool Visibility ~ To provide proactive education and management tips to political entities in the State of Texas regarding healthcare costs and information. The information needs to be timely, innovative and stress the alternatives that Texas Municipalities maintain in their healthcare benefit program.