Quality
Subscriber ID
Member first and last name
Date of birth
What is HIPAA review for a member?
Addressing caller Tonya Williams as Ms. Tonya.
What is innapropriate use of member first name?
IVR, HIM, HIPAA
What is jargon?
You can offer this to a caller but it is not necessary. If offered it is worth extra points.
What is self service or healthnet.com?
Negative statement about Centene, our vendors, or a government entity.
What is behaviors to avoid?
I understand that this can be confusing.
Clarifying statements like "I missed your name" or "You cut out can I verify your ID number", need to be used to ensure no point loss on .....
May I place you on hold for 2 - 4 minutes while I research that for you?
What is hold and transfer protocol?
_______________ must be completed during the call or immediately after completion of the call
What is documentation?
Thank you for calling Health Net.
What is thanking the caller and branding the call?
I'd be happy to assist with that.
What is a willingness to assist?
Agent is silent for more than 15 seconds with no explanation.
What is dead air?
What does the letter say?
What is a probing question?
There is a 3 seconds allowance for this
You can go here to verify your call quality
What is Uptivity?
"My goodness I see you just turned 60. WOW!"
What is inappropriate personalizing of a call?
"Um", "Let me see", "Uh, I just click this, then go here"
What is self talk?
The agent gives an answer without pulling up the member account up.
What is did not follow the relevant work process?
Is there anything else I can assist with?
What is offered further assistance?
Mishandling a crisis call may be scored this amount for the whole call in quality.
What is zero?
The caller clearly states the reason for the call and the agent asks "How can I help you today?"
What is active listening?
One moment while I look that up for you. Followed by a minute of silence.
What is a proper avoidance of dead air?
Instances where all information is provided and is correct, with the exception of a single piece of information, and when it is unlikely that there will be a significant negative impact to the caller.
What is partial credit?
Negative statement about Centene.
What are behaviors to avoid?
Who What When Where Why How
What is call documentation?