Small Talk
What is small talk?
A polite conversation about uncontroversial topics
What is good customer service?
Being respectful & kind
Satisfying the member's concerns
Being Prepared & Professional
Why is Phone Etiquette important?
It is the caller's first impression of you
How you communicate determines whether you gain or lose the caller and your interaction for the remainder of the call
What does HIPAA stand for?
List some Indirect Identifiers of PHI (Give 2 examples)
Fax #'s
Email Address
Health Plan Beneficiary #'s
Account #'s
Certificate/License #'s
What 2 main skills do you use during small talk?
Active Listening & Communication
What should you NEVER do on a call?
Become verbally abusive
Hang up on a member
Place member on hold for a long period of time
What are the five P's for Phone Etiquette?
1. Be Prepared
2. Be Patient
3. Be Proactive
4. Be Personable
5. Be Professional
What does HIPAA protect?
Protected Health Information (PHI)
What are the criminal penalties if you disclose PHI without consent? (up to 3 answers)
Civil Penalties: Up to 1.5mil per year per violation
Criminal Penalties: up to 250,000, imprisonment of up to 10 years or both
Lawsuits: Invasion of privacy/negligence
Why is small talk important?
You will forge stronger connections and the person will notice how engaged you are, becomes easier to ask relevant questions.
How should a customer feel after a successful interaction with us?
They should feel heard & respected
They should feel their needs have been met
What are four key customer service skills?
1. Patience
2. Attentiveness
3. Clear Communication Skills
4. Product Knowledge
What is HIPAA?
Privacy & Security of Health Information
Notification of breaches of confidentiality
Penalties for violating HIPAA
As a Clarks Resources Staff training on HIPAA privacy, what do you acknowledge when using PHI?
You are only given access to PHI if you need it to perform your job
You must agree to protect the confidentiality of the information
You are subject to discipline if you violate client/company privacy policies and procedures
What is unacceptable for small talk? Give at least two examples
Anything that may upset the member. Ex: Politics, Religion, Personal Finances, Gossip, Offensive Jokes
How do we create satisfied customers?
Create a calm atmosphere of mutual respect, trust, and satisfaction to quickly resolve customer concerns.
What are the 6 basic needs of customers?
1. Friendliness
2. Control
3. Understanding & Empathy
4. Options & Alternatives
5. Fairness
6. Information
What are some DO NOT's when safeguarding PHI? (Provide at least 2 answers)
Do Not Access PHI that you do not need
Do Not Access PHI with individuals who do not need to know it
Do not provide PHI to anyone not authorized to receive it
List the Direct Identifiers of PHI (Give at least 4)
Name
Medical Plan ID Number
Street Address Including City, State, Zip Code
Date of Birth (DOB)
Phone Number
Social Security Number - WE DO NOT USE
What topics are acceptable for small talk? (Give at least 2)
Pets, Weather, Sports, Music, Food, Music, Movies
What are some de-escalation techniques? Give at least 3
Stay Calm
Let Them Vent
Show Empathy
Recap & Confirm
Ask if there is anything they would like to add
Apologize
Find a solution
Make good on your promises
What are Clark Resources core values?
•Responsibly provide a great member experience
•Empathize with the needs of each member
•Support the client’s mission
•Passionately take the extra step to assist members
•Encourage our colleagues to be the best
•Care for both our internal and external customers
•Thankfully accept our careers & the opportunity to make a difference in the lives of others
How does HIPAA protect PHI? (Give 3 examples)
Limits on who may use or disclose PHI
Limits the purposes for which PHI may be used or disclosed
Limits the amount of information that may be used or disclosed (Minimum Necessary Rule)
Requires use of safeguards over how PHI is used, stored & disclosed
What is the only allowable direct identifier to be provided when leaving a voicemail?
NONE...When leaving a voice message, it is important not to include any PHI