Helping Members
members expect their issue to be resolved, however our job aids cannot possibly cover every possible scenario
Embrace the Gray
Abused, Empty, No one understands, Agitated, Feel like crying, Only want to eat, Alone, Helpless, Restless, Anxious, Hopeless, Sad, Bullied/picked on/afraid, Irritable, Scared, Cannot go on, Isolated, Stressed, Cannot remember things, Mad/angry, Suicidal, Cannot sleep, Nervous, Cannot stop crying, No appetite, Want to hurt someone, Depressed, No energy, Worried, Do not feel right, No interest, Worthless, Emotional, No one cares
Trigger Words
When transferring a member without conferencing. Warm introduction may or may not be needed. Refer to the Contacts Tool to confirm.
Carrier Redirect
An opportunity to see if member is interested in identifying resources in their community
SDOH
This job aid provides information on how to request assistance with callers who do not speak English and need help scheduling in-office appointments.
Language Line and Interpreter Request
Transferring member to direct internal line, usually pre-selected in the VCCD dropdown menu for you.
Warm Transfer
Process advocates must follow when assisting members with obtaining assistance with complex care needs and to assure timely referral of members identified by Member Services
Referral to Case Management
Team that supports Advocates with Complex Issues
What is SME/Nest Line
Transferring to an internal number when no warm transfer is required. Usually pre-selected in the VCCD dropdown menu for you.
Cold Transfer
When you need to complete additional research and call the member back
Commitment Handling/Setting a Commitment
Active Listening, Acknowledge Emotion, Show compassion, respect the member, Offer assistance and ask probing questions
When you have no intention of transferring the member. This option would only be used when you need to contact another party for additional information (you may need to join all three parties) and then return to the original caller.
Warm Conference
When seeking more detail and providing the best service, there are different types of techniques you can use
Probing Questions
Process to handle behavioral health, emergent or potential crisis calls
Crisis Intervention Behavioral Health
Outbound calls when the member is not on the line.
Standard Dial