Categorization
Member called in and they advised that they had been trying to get in contact with their navigator and they never return their phone calls.
Call Center -- Advocate interaction
Member called in and stated that her doctor is rude and that he delays in referring her to specialist
Two Grievances
Member called in and advised they started with the plan beginning of this month but have not yet received their Ucard, What is your categorization?
UCard/Card Not Received/Incorrect
Member had dental appointment. He is upset that he waited for an hour past his appointment and still hadn't been seen. Transportation arrived to pick him up to go home. Member cancelled the appointment and went home with transportation.
QOC
Where is UHG Headquarters ?
Minnetonka Minnesota
Member was advised by an agent that their pain management doctor took both Medicaid and Medicare but when they got to the office they did not take Medicaid, what is your categorization ?
Call Center -- Advocate - interaction
Member called in they advised transportation missed their appointment and when they called in to transportation ask about their ride the agent was rude.
Two Grievances
Member has attempted to get an appointment to see his PCP but they will not answer his calls, what is your categorization?
Provider/Prescriber -- Unable to get an appointment / refuse to see member
Member stated office staff was nice and he likes the doctor. Member just doesn't think the doctor is taking his concerns seriously. Provider keeps saying, "That's old age for ya!"
QOC
What are the three lines of business that create our company ?
UnitedHealth Group , Optum, United Healthcare
Member called in stating they waited in the doctor office for an hour after their scheduled appointment time before being seen.
Plan --- Provider/Inadequate Care (QOC)
Member called in to advise that transportation missed their ride however their neighbor took them.
One Grievance
Member is upset that Optum calls her to remind her to refill her medications.
Optum RX/ Complaint about OptumRX Customer Service
Member got a transportation ride to his appointment but he noticed the driver was not wearing a mask and saw bed bugs crawling on the seats
QOC
What recognition is given by peers when they appreciate your work?
BRAVO!
Member calls in and he advises that we have the incorrect spelling of his name on his id card and system, what is your categorization ?
Plan -- Member Demographics
Member called asking how to pay her utility. The representative told her he didn't know how to do it and needed to talk to Solutran. He transferred her to HB+ to pay over the phone but was advised her utility is not on the list. She is upset about the whole call.
Two Grievances: Call Center/Advocate Interaction
and Ucard/Utilities and Food
Member calls in and advises that the broker misinformed them about the plan benefits, what is your categorization?
Sales Agent/ Broker
Member doesn't like that he has to fill out paperwork when he visits a new provider, he just wants his records to be transferred.
VG
What is our Social Responsibility Mission?
Helping Build Healthier Communities. We do this through Our People, Our Partners and Our Foundations.
Member calls in and advises that UHC auto assigned another doctor and they don't want to see that new provider what is you categorization ?
Plan-- Plan Benefits
Member is upset that when she called Solutran on 3/6/23 and 3/10/23 to pay her utility bill, she spoke with representatives that were extremely difficult to understand. Member stated that both conversations led to levels of frustration because the member couldn't understand the reps and they couldn't understand her. She stated that she understands we have a diverse workforce but she wants to speak with someone that is able to be understood and that understands her.
One Grievance:
An issue/complaint with multiple dates can be documented in one intent including the span of different dates.
An issue/complaint falls under the same reason and sub-reason, only 1 intent is needed.
Member calls in and advises you that he has requested his PCP submits a PA for a wheelchair, but provider does not, what is your categorization?
Provider/ Prescriber -- Poor Provider/ Facility Service
Member is dissatisfied that her HB+ benefits don't roll over month to month.
VG
What is UnitedHealthcare's vision?
To deliver the most affordable coverage; simplest experience; adn highest quality, supported care.
Our Vision (sharepoint.com)