QA
NEW QA SCORING GUIDLINE
HIPAA
General
SOMETHING ABOUT OUR TEAM
100

when should we offer reward card

the reward should be mentioned on a refusal call.

if member is not familiar with HouseCalls

if member has questions about reward 


100

how many points we loose if we don't brand correctly

14


100

Outbound HIPAA Verification

TeamCare HIPAA Verification Standards - Outbound HIPAA Verification - Member

This policy is to be used for Outbound Calls with members to verify HIPAA.

Scheduling coordinators must obtain the following information for each member for whom they are verifying HIPAA:

  1. The first and last name of each member whose protected health information (PHI) is being requested.
    • The full members full name cannot be mentioned before HIPAA verification (see exceptions).  
    • Scheduling coordinators may only state the first or last name before HIPAA verification (see exceptions).
    • This also includes abbreviated first names (i.e., scheduling coordinator verifies the name on file was Edward when the member stated their name was Ed.)
  2. Only one of the following pieces of information about each member:
    1. Subscriber ID or Member ID number
    2. Complete physical or mailing address
    3. Full date of birth (DOB)
100

how many coaching meetings we have a month

2


100

Lives with husband and ex husband

Christi

200

when to skip the 4 key points?

Scheduling coordinators may skip the Four Key Points if any member, regardless of cohort, states they are familiar with the HouseCalls visit and does not have any questions about what the visit entails.

200

Ho many section we have in the scoring guidelines

3


200

Jackpot

Jackpot 

200

how many one on one meetings we have per month

1


200

MASTER CHEF: Liver and Onions

Jorge

300

when should we handle reluctance

 on every refusal call.

300

No Availability verbiage?

Our Program is extremely popular I will reach out to the Clinician to coordinate a time that meets your needs. Once we connect with the clinician a member of my team will reach out to you to schedule the appointment. what is the best number to reach you at?

300

When should we complete the non member process

when we are talking to a non member

300

what status we use for one on one

Team Meeting

300

 has a beautiful voice

Jennifer

400

when should we offer toll free number

SC must offer the toll-free number ON EVERY OUTBOUND CALL

SC must offer the toll-free number on transfer calls.

400

KB0022290

Reluctance Scenarios

The chart provided  illustrates several reluctance scenarios with their respective empathy and value suggestions.

400

What is the source of truth

call script

400

Rosa?

Erandi

400

Model

Jovon

500

when we don't have to status an account

member already scheduled the visit

member already completed the visit

500

KB0023276

TeamCare HIPAA Verification Standards - Recording Disclosure - Member

When speaking with a member, the recording disclosure MUST be provided on all outbound calls prior to requesting or releasing PHI and before the HIPAA verification process.

Scheduling coordinators may use the following verbiage as their recording disclosure:

           “I would like to advise you that this call is being recorded.”

“I would like to advise you that this call is being recording for quality control purposes.”

500

Inbound HIPAA Verification

Scheduling coordinators must obtain three pieces of information for each member for whom they are verifying HIPAA:

  1. The first and last name of each member whose protected health information (PHI) is being requested
    • The member's full name cannot be mentioned before HIPAA verification (see exceptions). 
    • Scheduling coordinators may only state the first or last name before HIPAA verification (see exceptions).
    • This also includes abbreviated first names (Ex: Scheduling coordinator verifies the name on file was Edward when the member stated their name was Ed.
  2. Two of the following pieces of information about each member are required:
    • Subscriber ID or Member ID number
    • Complete physical or mailing address
    • Full date of birth (DOB)
    • Phone number
      • If the phone number being used to speak with a member is already listed on the account(s), it can be used as one piece of HIPAA verification by stating it out loud.
      • If scheduling coordinators are able to speak with the member on a Wrong/Invalid phone number, this number can be considered as a piece of HIPAA  verification for the current call. However, scheduling coordinators must mark the phone number as Wrong/Invalid accordingly.
500

when is February QVC Payout

April 26th, 2024


500

 doesn't complain 

Vinny