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SCG is Awarded Contact Center Eligibility Determination Support for the Affordable Care Act Health Insurance Exchanges and Marketplace

Morgan Whipps

NOV. 6, 2023

Signature Consulting Group (SCG) will support the Centers for Medicare & Medicaid Services (CMS) eligibility determinations for the Patient Protection and Affordable Care Act (PPACA or ACA) Health Insurance Exchanges.

SCG contact center customer service representative (CSR) will make eligibility determinations for enrollment into a Qualified Health Plan (QHP) and for insurance affordability programs. As a subcontractor on the Marketplace Eligibility Support Contract (ESC), SCG’s CSRs will manage and perform quality intake processes, verification, and resolution of applications for eligibility into the ACA exchange marketplace program. SCG will provide contact center operations, customer satisfaction management, quality management tracking, service level management, ACA eligibility subject matter expertise (SME), and standard operating procedures (SOP).

SCG’s work with ACA Health Insurance Exchanges directly supports CMS’s strategic vision to serve the public as a trusted partner, advance health equity, expand coverage, and improve health outcomes. This work advances the strategic goal of health equity by addressing disparities that underlie the US health system, building on the ACA, and expanding access to quality, affordable health coverage, and care.

This Contact Center Eligibility Determination work further expands SCG’s footprint supporting CMS’s ACA Marketplace in the Center for Consumer Information and Insurance Oversight (CCIIO) program. SCG’s work with CCIIO includes: 2024 and 2025 Payment Notice public comment evaluation and management, Health Equity (HE) expertise and education training to the Marketplace program, and Independent Statistical Analysis methodological approaches to CCIIO payment policy program auditing strategies.

About Signature Consulting Group

SCG is a woman-owned small business (WOSB), focused on Healthcare IT, specializing in digital services, data analytics, and quality assurance and performance improvement and efficiency. SCG’s healthcare services drive innovative, flexible, and scalable health IT systems to optimize health operations by leveraging technology, data, and quality management for Federal and commercial clients.

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