Provider Support Processes
True or False: The ‘No Response Required’ tag applies to Provider Support outbound emails.
False! We use this tag when no work has been done or needs to be done. Example: Received voicemail where a callback is not needed due to not enough information or spam inquiry.
When filling out a JIRA ticket, what is the new 'Summary' expectations?
{Provider Name} - {Subject Line Regarding Inquiry (use the CS Guide for examples}.
What is the required initial response time to meet quality chat and call expectations?
Chat: 60 seconds or less
Call: 45 seconds or less
When creating a ticket, who is required to be listed as the 'Assignee' and the 'Reporter?'
Initially, the agent creating the ticket should be listed as both. Later, the Assignee can be transferred to another agent if they are taking over. Reporter should never be changed.
Remember: CASE TICKETS SHOULD NEVER BE LEFT AS UNASSIGNED.
What are the expectations to complete a successful Weekly Jira Update?
You are required to update the provider/ admin once a week with any updates related to the ticket.
You will need to check the status of all of your tickets in JIRA and the MedPass associated with it at least twice a week or every time you receive a new notification.
If you have not received an update after a week:
❏ Request one in the ‘Activity’ section of JIRA.
❏ Update the provider/ admin with an appropriate email template (located in the ‘Outages/Issues’ folder).
❏ Add a note to your JIRA ticket using the WEEKLY SF UPDATES - No Updates template.
If you have received an update:
❏ Troubleshoot if required, and respond back to the Engineering team appropriately.
❏ Update the provider/ admin with an appropriate email template (located in the ‘Outages/Issues’ folder).
❏ Add a note to your JIRA ticket using the WEEKLY SF UPDATES - Resolved template.
If you do not receive a response by EOD on the 2nd day AND you are able to proxy login okay with no issue, you are okay to move forward with requesting that the ticket be closed out along with your JIRA ticket.
Lastly, confirm with the agents completing the weekly JIRA Updates Slide, as well as any and all updates you have received or requested. In addition to if the status or assignee has changed.
When a Provider Support voicemail comes into our Customer Service inbox, what do we do?
Note: Two answers.
1. Separate all voicemails as individual conversations 2. Assign to Becky Thompson or approved PS Agent
If a client is not listed in JIRA yet, what do we do?
Add the client to our 'JIRA - Items Needed' spreadsheet and select 'Contact Center Admin.' Then, when the client is added, go back to the ticket and select the right account.
What are the expectations when documenting your description?
Inquiry details, Troubleshooting steps, Resolution, Closing statement, and Message ID for Inquiry email and Response email.
What does 'In Progress' status mean?
Any tickets that are currently being worked.
Note: there should not be any tickets left as 'In Progress.'
What is a Weekly PII update?
A weekly PII update is an email request from our client (Northwestern) to update name changes for providers in CheckMedic. Then, report our changes back to them.
When a Provider Support agent sends an outbound email, what are they required to do?
They are required to tag their emails as a Provider Support inquiry, add specific inquiry type tag, confirm their signature is changed to the Provider Support signature, and add RC Contact ID for call inquiries.
How do we link a ticket from JIRA to Front?
(Ex: email).
Click on 'JIRA' on the side bar (bottom right) > 'Search' > Type 'Contact Center' under Project > Search the issue name > Once an issue loads click the three dots to the right > 'Attach Issue.'
What is our required SLA response time for emails, faxes, and voicemails?
All emails, faxes, and voicemails must be responded to within 8 business hours. Even if you do not have an answer/ resolution, you must at least respond to acknowledge the inquiry within 8 business hours. Any emails not responded to within the 8-hour timeframe will count against our SLA, and leadership will be tracking breaches on an individual level.
Why would you use CONTACT CENTER ADMIN as the client when creating your ticket?
Incoming sales inquiries- not listed in the Client List spreadsheet
Insufficient information- not enough info in inquiry to know the client (should be updated with the client name once received)
Incorrect company (ex. NPI)
What are the DTM expectations?
You are required to manage our CS Inbox by delegating all inquiries appropriately to agents, answer all Chats, complete High Risk Notifications, and check the 'Trash', 'Snooze', 'Spam', and teammates' folders throughout your entire DTM Shift.
Before assigning an incoming email to a Provider Support agent, what steps need to be completed?
1. Check to see which Provider Support agents are available.
a. Provider Support agents should have the correct status in Front, but you can confirm by looking at the RC dashboard.
2. Assign email
3. Monitor email to confirm it's being worked on.
a. If email is not worked on within 2 hours, use the Google Chat to reach out to the Agent.
How do we link two tickets in JIRA?
Click 'Link Issue' (upper left) > Change 'Is Caused By' to 'Includes' > Search and click on issue > 'Link.'
After the CPI/ OS ticket is resolved, the inquirer will need to confirm the resolution on their end or confirm if further issues are occurring. If the inquirer does not answer on your first attempt. How many attempts in total are required before closing your case ticket?
A total of three attempts are required before closing the Contact Center ticket.
When is an internal comment required?
To document additional interactions, to add closing statements, to add weekly updates, to request additional assistance, and to reply to the team if additional details are needed regarding the case ticket.
Which FACIS Match Category does not allow the individual or entity to be able to practice?
3- State-level sanction or disciplinary action is present, and the individual or entity is unable to practice.
When determining if an email inquiry is for Provider Support, what are the key words to look for?
- Aperture
- Reference Code/ TCC Code (codes are currently starting with the letter A)
- Re-credentialing Letter
- Clients within the 'List of Legacy Aperture clients 1.1.2024' spreadsheet
- Referencing the 'Provider Support In A Nutshell (No Advantage) presentation.
What is the difference between a JIRA Board and JIRA Queues?
Contact Center Jira Board: A space where we should not delegate work.
Contact Center JIRA Queues: A space where all case tickets are listed and filtered by status. The Team should be working only from this space.
What are the expectations to receive full points for Troubleshooting and Resolution?
Completed all troubleshooting steps (depending on the type of inquiry)
Asking probing questions
Created Jira CPI/ OS Tickets if necessary
Provided follow up steps
Advised to complete and submit the MP (if needed).
What is the difference between a cancelled ticket and a closed ticket?
Canceled Tickets
A ticket should not be moved to ‘Canceled’ status unless:
Test tickets were created for training
Approved by the CS Manager
Note: As a department we want to avoid canceling case tickets.
Closed Tickets
All incoming interactions need to be documented. After a case ticket is completed and inquiry is successfully worked and fully completed, then the ticket will be moved to 'Close'.
What is the difference between Clear and Complete Clear?
Clear (Walmart Only): The information in the MedPass has been verified. This status can be added after the verification process is complete and the MedPass came back with no assess results or added by a Walmart admin after reviewing a MedPass with assess results and clearing them for onboarding.
Complete Clear: The information in the MedPass has been verified. This status is added after the verification process is complete and the MedPass came back with no assess results.