Policies
When you would like to appeal a QA evaluation, Do you have to reach out to leadership for approval?
Yes, Leadership must approve the appeal can be submitted and then you can submit the appeal.
What is our score for level 5 C-Sat?
95%
Where do we need to add our notes in CRM?
Add all details of the call in the comments section
Member called and wants to check the status of his Amazon Order including when it will arrive, what items are on the order, and what address the order was shipped to. Which KIP article would you follow?
12.2 Amazon Order Status
Members can purchase gas at the pump at any gas station that accepts VISA if that is part of their benefit. True or False.
True.
To be eligible to receive pay for a holiday you do not work, you must work the day before the holiday. True or False?
False, to be eligible to receive pay for a holiday you do not work, you must work the day before and after the holiday.
What is our score for level 5 QA? (For QVC purposes only & recently updated starting OCT)
90%
When member states the reason for call, what would we say next?
Provide I statement. Example: I am more than happy to help you replace your card today.
Member wants to access their Visa card number in the Healthy Benefits Plus mobile app. Which KIP would you follow?
21.10 Access Visa Card:Mobile App
A Utility Company calls directly and requests to be added as an eligible provider. Which KIP article would we follow?
15.15. Utility company calls to be added to eligible utilities or requests to change payment method
How many occurrences are required before being placed on an initial corrective action plan?
4
What is our score for level 5 Adherence (Recently updated starting OCT)?
95%
When we need more time to gather information for member, what is the hold expectation?
Check in with member every 2 minutes.
Member said she is not happy with the service. Which KIP article would you follow?
What is the first step on the kip article for cancel items or orders?
10.3, step 1. Ask probing questions.
You receive overtime pay for all reported work hours that exceed 40 hours in a regular work week. True or False?
True.
What is our goal for level 5 AHT T2?
<575 seconds
UHC Ucard member (Not Masco or Group Retiree member) asks for assistance to navigate the digital Ucard via MyUHC mobile app. Do we transfer to health plan or assist member?
Transfer to UHC for assistance if needed. See 21.1 Download the Mobile App
Member states he is trying to make a payment and the company information is entered incorrectly. He states why is he having such a hard time making a successful payment? What would you tell the member?
"While we are regularly monitoring for payment delivery and processing issues to service providers, unexpected errors may occur. I can attempt to submit the payment again or I can provide other ways to use that benefit now" See 15.1 Utility Bill Pay FAQS.
UHC member submitted an online order that was received before benefits expired, but the order was not processed until the new benefit period. This resulted in the order being placed with the new benefits instead of the previous benefits. Does that qualify as an expired benefit dispute?
Yes.
The opportunity to participate in an incentive plan is provided to all regular employees to reward and recognize their performance and contribution toward the company's success. What is the compensation policy called?
Quarterly Variable Compensation (QVC) Policy
What is our goal for level 5 AHT in T1?
<480 seconds
What are the steps in order in the call flow process?
1. Greet the caller 2. Search in CRM 3. Verify 4. Request Phone Number 5. Check for banner 6. Understand caller's needs 7. Demonstrate Willingness to Assist 8. Resolve Reason for Calling 9. Offer Additional Assistance 10. Provide Benefit Recap 11. Convey Appreciation 12. Complete Call Wrap Up
Can members use S3 rewards to pay for utilities?
No, they cannot currently use their reward for Bill Pay. See 15.1. Utility Bill Pay Faqs.
Highmark Member called Healthy Benefits Plus Member Support on the last day of the benefit period and did not reach a representative until after the benefit expired. Does that qualify as an expired benefit dispute?
No, Highmark does not approve benefit extensions. See 16.3 Expired Benefit Disputes.