System documentation
To meet the requirements of System documentation, name two things you must accurately document.
What are Insurer Type, Member/Provider, Eligibility Date Span, Inquiry Type or category type?
To fulfill the very first requirement of System documentation – Call Logs, these specific elements must be physically copied and pasted into CSM.
What are AI notes?
To score a World Class rating on Offer additional assistance, you must offer additional assistance on every single call, explicitly including these two tough scenarios.
What are transfers and misrouted calls?
When wrapping up a call that requires further internal routing, you must select this specific field accurately when sending follow-ups under this section.
What is the correct department (Dept/Individual)?
This section mandates that these three specific categories of auto-populated information must be added to your notes.
What are FAP, claim/auth and any additional auto populated information?
Under Offer additional assistance, saying this specific two-word phrase results in an automatic DNM score of 0.
What is “Anything else?”
When referencing dates in this section, you must select these two specific timeline elements correctly.
What are eligibility/date span?
Beyond auto-populated text, your log notes must ensure that all of these specific parameters are added.
What are client specific requirements?
For specific contracts (like Healthy Blue or Wellpoint), this section states you must ask these to avoid a zero and an immediate escalation email to management.
What are mandated FCR questions?
This section states you must expand your dropdown entries by doing this action when it is applicable to the call layout
What is Add additional inquiry types?
According to the “Score as 0” scoring guidelines for this section, what action triggers an automatic zero involving the live discussion?
What is Information was added to the log that was not discussed?
The Closing section states that a proper closing must explicitly contain these three strict requirements to earn a World Class score.
What are thanking them for calling, a personal appreciation statement, and energy/enthusiasm?
Under this section, this specific piece of communication data must be actively obtained when handling a follow-up scenario.
What is a call back number?
Aside from fabricating details, the scoring guidelines state a call log will be scored as a 0 under this specific condition.
What is No call log was made?
Quote any one of the five specific examples of a World Class Closing statement provided word-for-word in the Closing section guidelines.
Any one of the following is correct:
“Thank you for calling, it’s been a pleasure assisting you today”
“Thank you for calling, I hope you have a better day”
“I appreciate you calling us today, I hope you have a great day”
“I greatly appreciate your time today and thank you for calling us”
“I truly hope things get better for you soon, thank you for calling and take care”