Escalation Best Practices
PHI/HIPAA
Patient Services (PS)
Home Sleep Study (HST)
Digital Scheduling
100

When do we escalate for unresponsive clinics?

At least 3 separate attempts have been made to contact the clinic.

100

On inbound call, how many pieces of information MUST be verified?

2 Pieces

Or 

First, Last Name, and 2 additional pieces of information. ( Phone#, Email, or DOB)

100

What is the proper way to transfer a patient to PS?

Provide the patient with the phone # and warm transfer to PS.

100

What does HSAT stand for?

Home Sleep Apnea Test

100

DS should be offered when?

As a first option to scheduling an appointment

200

When do we NOT escalate an existing patient to PS?

Do not escalate if the patient has been warm transferred successfully to Patient Services.

200

On an Outbound call, how many pieces of PHI must be verified?

2 Pieces

OR

First/Last Name, and 1 additional piece of patient information. ( Phone#, Email, or DOB)



200

What is the contact information for PS?

844-672-6720, or email Support@InspireSleep.com

200

Is Lofta covered by insurance?

Home Sleep Study that is cash only.

200

When a patient's insurance does not contain a group #, what should be listed in the online portal?

N/A

or

0

300

What is considered a Device complaint?

Negative Feedback on Inspire, Clinic, or Physician

300

What is NOT considered a form of PHI?

Zip Code

300

Who should be transferred to patient services?

Current Inspire Therapy Users reporting ANY concerns, questions, or issues with the device/remote.

Pts reporting Side Effects

Patients needing assistance with troubleshooting the Inspire Therapy Application

Current Inspire patients who have moved to another state and need assistance finding a new provider for ongoing care with Inspire device.

300

Which insurance does OGNOMY not accept?

UHC except Traditional Medicare/UHC Medicare (Advantage) Plans

300

When using DS, the online portal states to call the clinic. are we able to call the clinic? 

Yes, we can ONly call the number listed in USD.

400

How do we properly add a patient to the DNC list?

Escalate and leave detailed notes to add the patient to the DNC list.

400

During an Outbound call, when should an advisor confirm the patient's PHI?

Before stating the purpose of the call

400

What information should be provided to PS advisor when transferring?

-Patient Name

-DOB

-Callback Number

-Synopsis of what the patient is reporting

400

When do you transfer to HST?

Clinic notes indicate OG or Lofta

The patient timeline indicates OG or Lofta

The patient was referred by the doctor to schedule an HST.

400

Process if DS is not working?

Utilize the Ds link in the spreadsheet 

If this does not work, utilize the clinic's next option "(Call or Email_

500

When do we escalate for digital scheduling issues?

No availability, the accepted insurance was not on the list, or the physician was not in the clinic note.

OR 

Any other problem with the Digital Scheduling portal, Clinic Notes, or Digital Scheduling Links. It is  

500

If a caregiver is calling/answering for a patient, must the ACP agent must verify?

First Name, Last Name, 2 additional pieces of patient information.(Phone #,Email, DOB)




500

Process for deceased patients

Existing Inspire Patients that have passed way, please WARM transfer to Patient Services. Please collect the following information.

-Patient Name

-DOB

-Callback Number

500

Which type of HST requires follow-up to schedule a consult or to make sure a consult appointment was made?

Ognomy

500

If the clinic location the pateint called in about does not have availability are we able to schedule at an alternate location? Even if not listed in clinic notes.

Yes

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