Show:
Warm Transfer or Conference Call
Soft Skills and Behavioral Skills
Call Pathway: Benefits
Call Pathway: Payments
Enter Call Pathway: Delegated Vendors
100

Case Management

What is Warm Transfer?

100

Be Attentive

Ask Probing Questions


What is Active Listening?

100

Step taken after looking up a doctor for the caller.

What is offering to make a doctor's appointment while the member is on the phone?

100
"Are you aware of our convenience auto-payment option?"

What is Educating the Member on Auto-Pay Option?

100

1-800-433-6825

What is the number to Horizon Dental
200

Prime Therapeutic

What is a Conference Call?

200

An objective and resolution-targeted thinking approach.

What is Critical Thinking?

200
"Yes, Dr. Jones is in network. He's a Tier 2 provider. If you are open to seeing another provider, I can locate a Tier 1 provider, which will save you money."

What is providing OMNIA cost-savings options to the member?

200
"I can certainly take your payment today. Do you have your payment information handy?"

What is taking a payment?

200

1-855-243-3321

What is Care Centrix's phone number?
300

Davis Vision (Member has vision coverage)

What is a Conference Call?

300
Taking ownership, de-escalating emotions, and using transition phrases.

What are Examples of Call Control?

300

"If you have a few minutes, I would be glad to show you how to use our on-line doctor and hospital directory."

What is Educating the Member on the on-line Doctor/Hospital Finder?
300

"Yes, we received your payment of $343.27 on January 15."

What is providing a status of a payment?

300

1-866-969-1234

What is EviCore's phone number?

400

Utilization Management

What is Conference Call?

400
"I can assist you with that!"

What is Confidence?

400

"Are you aware that ABC Hospital is not in the OMNIA network?"

What is advising member when OON provider is selected?

400

"Are you aware you can update your payment information on the member portal?"

What is educating the member on the member portal?
400

1-800-626-2212

What is Horizon Behavioral Health's Phone Number?

500

Behavioral Health

What is Warm Transfer?

500
At times it requires delivering the "painful truth" both confidently and compassionately.

What is Resolution?

500

"Would you like to speak to someone about a vision plan?"

What is Educating the member on benefits?

500

"Your reinstatement is all set. I'm reviewing your claims history now to check for any eligible claims adjustment."

What is handling a reinstatement call?
500

1-800-424-4508

What is Magellan RX's phone number?