Scheduling
MEMBER: "They never answer the phone."
Which CARE behaviors should be demonstrated in your response?
"I can understand how frustrating that must be. Would you be open to exploring additional provider options that may have better availability?"
✅ Connect and Empower
Member says: "I don't have a ride."
✅ Answer: Transportation Need
Reflection:
Why could this affect healthcare outcomes?
What listening skill involves repeating information in your own words?
Paraphrasing
What type of question is this:
"What would you like help with today?"
Open-Ended
Which CARE behavior comes first?
Connect
Member says: "I can't find anyone accepting new patients."
What questioning technique is being used?
Sample: "I'd be happy to look at additional providers in your area. Would you be open to nearby locations or telehealth options?"
Probing questions.
Member says: "I've been staying with family."
✅ Answer: Housing Insecurity
Reflection:
What follow-up question could you ask?
"It sounds like you've had a difficult time getting answers."
Reflective Listening
What type of question is this:
"What happened after your visit?"
Probing
What CARE behavior is this:
"Thank you for bringing this to my attention."
Appreciate
Member says: "I forgot my appointment again."
Which CARE behaviors should be demonstrated in your response?
Agent Must:
✅ Sample Answer: "I know it can be difficult to remember appointments when life gets busy. Let's look at reminder options that may help. We can explore text, phone, or calendar reminders so you can choose what works best for you."
Member says: "I'm so lonely all the time."
✅ Answer: Social Isolation
Reflection:
Why is this important to recognize?
True or False: Listening only for facts is active listening.
False
"When you say they canceled it, are you referring to the clinic or the provider?"
Clarifying
What CARE behavior is this:
"Before we finish, let's review the next steps so you know exactly what to expect."
Empower
Member says: "The provider's next opening isn't for three months!"
Create a CARE response.
✅ Sample Answer: "I understand that's disappointing. Thank you for sharing that with me. Let me check for additional providers or earlier openings. I'll also explain all available options so you can make the best decision for your care."
Member says: "I'm choosing between paying for groceries and picking up my medication."
✅ Answer: Food Insecurity / Financial Strain
Facilitator Discussion:
What may be the real need behind the statement?
Challenge: Reflect this statement:
"Nobody ever calls me back."
Sample: "It sounds like you're feeling frustrated because you haven't received the communication you expected."
"It sounds like affordability is your biggest concern."
Reflective
What CARE behavior is this:
"Let me review your options and see how I can help."
Respond
Scenario: A member has called three providers and cannot schedule an appointment.
Team Must Identify:
✅ Example: Connect: "I can see how frustrating this has been."
Appreciate: "Thank you for continuing to advocate for your care."
Respond: "Let me help identify additional providers."
Empower: "I'll review options with you so you can decide what works best."
Member says: "My social security check does not fulfill my needs."
✅ Answers: At least 2
Challenge: Why is understanding emotions important before solving problems?
Sample:
Because members want to feel heard and understood before they can fully engage in problem-solving.
What type of question is this:
" Do you have any preference for your provider?"
Probing
Challenge Round
Member says: "I've called three times and no one has helped me."
Sample Answer
Connect: "I understand how frustrating that must be."
Appreciate: "Thank you for continuing to follow up."
Respond: "Let me review your situation and see where we can help."
Empower: "I'll explain the next steps so you know what to expect after today's call."