CALL OPENING
What statement shows the caller you understand their concern?
Acknowledgment
What type of question gathers facts about the situation?
Situation Question
What should be given when options are available?
Solution and Options
How many identifiers are required before releasing information?
Three
What must be obtained before placing a caller on hold?
Permission
What should every call begin with?
Proper Greeting
What type of question uncovers the caller's problem?
Issue Question
What step confirms the caller understands the solution?
Gain Acceptance
What member identifier is preferred for authentication?
MRN/HRN
What kind of transfer is preferred when appropriate?
Warm Transfer
What type of tone earns full QA points?
Professional Tone
What type of question confirms understanding?
Validation Question
What summarizes the important points discussed?
Recap
Besides identifying the caller, what else must be verified?
Relationship to the Member
What question ensures all needs are met before ending the call?
Is There Anything Else?
What statement shows ownership and willingness to help?
"I Can" Statement
What is the purpose of probing?
Identify Customer Needs
What should follow a recap when applicable?
Next Steps
What QA section is worth 10 points?
Caller Authentication
Name one required documentation element.
MRN, Caller Name, Call Flow, or Resolution
Before asking questions, what should the CSR do?
Ask Permission & Explain the Benefit
What three question types should be used together?
Situation, Issue & Validation Questions
What helps ensure First Call Resolution before ending the call?
Recap and Next Steps
What happens if PHI is released to an unauthorized person?
Automatic Fail
Name one Automatic Fail.
HIPAA Violation, Unauthorized PHI Release, Inappropriate Hang-Up, Profanity, Personal Business, Failure to Assist, or Password Reset Policy Failure