QA Philosophy
True or False: Agents receive a traditional percentage or point-based numerical score on every QA evaluation.
What is False? (The model features NO individual QA scores; it focuses on behavior, tags, and feedback).
This pillar ensures that the agent keeps the provider's Protected Health Information secure.
What is Security and Compliance (HIPAA)?
This is the ultimate golden rule of case notes at Tebra.
What is "If it's not in the Salesforce feed, it didn't happen"?
This AI tool is the only generative AI platform approved for agents to use when searching the knowledge base for customer troubleshooting steps.
What is Forethought AI?
Disconnecting a live call or performing unauthorized actions to avoid taking a customer interaction falls under this severe classification.
What is System Manipulation / Intentional Disservice?
This specific type of summary uses a strict, single-sentence format detailing Root Cause, CX Impact, and Action.
What is an Insight Summary statement?
If you experience dead-air or keep a customer on a hold that approaches the 5-minute mark without checking in, you are slipping in this pillar.
What is Time Management?
Case summaries and details must always be written in a style that is clean, clear, and ready for this specific audience.
What is Customer-Facing / Client-Ready?
This internal platform tool is strictly prohibited for customer issue troubleshooting or copy-pasting code blocks. Best used for searching for Jira tickets.
What is Slackbot AI?
This critical error occurs if an agent actively argues with a client or behaves unprofessionally during a high-friction call.
What is Argumentative / Disrespectful behavior?
These are the three of the six core focus items that the Quality Intelligence Model uses to replace traditional numerical grading.
What are Behavioral Focus, Calibrated Feedback, and Actionable Coaching Trends?
Calming an upset provider and validating their frustration falls squarely under this evaluation pillar.
What is Empathy & Professionalism?
These notes are hidden from the client and should be utilized to reference internal support tools and Confluence articles used.
What are Internal Notes?
You select this specific case status when an interaction is completely finalized on the phone, which automatically triggers a customer satisfaction survey.
What is Resolved?
If an agent intentionally fails to place a callback to a customer when a call drops or a promise is made, they trigger this specific error.
What is Not Contacting the Customer Back?
Complete the foundational phrase that guides the entire QA philosophy: "When Quality Leads The Way, _________ _________ _________."
What is "Customer Loyalty Follows"?
Failing to use effective probing questions or providing inaccurate details drops points in this specific category.
What is Troubleshooting Accuracy?
These are three of the mandatory fields that must be populated inside every Salesforce case layout.
What are Account Name, Contact Codes, Tebra Platform, Subject, or Description? (Accept any three).
This specific case status is utilized when a ticket is at a standstill because you are waiting on a third-party vendor like TriZetto.
What is Pending Reply - Partner?
Failing to transfer a customer to a supervisor after they make an explicit verbal request results in this severe process violation.
What is Denying an Escalation?
This is the exact, chronological 5-step sequence found on the "Quick Checklist" that an agent must execute during every live production call.
What is:
Verify User (Support Tools)
Troubleshoot via Forethought/Help Desk
Hold Timers (Within 5 minute increments)
Document via Salesforce Templates
Closing Script (Thank you for contacting Tebra Support!)
This category evaluates whether an interaction is documented completely within Salesforce or if improper templates were used.
What is Documentation?
True or False: Examples and specific platform paths are optional when logging a case summary.
What is False? (Summaries must be clear, concise, and feature exact examples and paths).
This is the centralized platform and internal site where an agent can access all public and internal SOPs to assist with troubleshooting and solving customer inquiries.
What is the Tebra Knowledge Base / Help Center?
Sharing restricted data or failing to verify a secondary user who just jumped onto the line triggers this type of automatic zero-tolerance error.
What is a Security / HIPAA Violation?