Show:
Universal Call Flow
AI Calls
2024 CCR Goals
Abbreviations
Miscellaneous
100

What is the resolution and closing statements?

Did I cover all of your reasons for contacting us today? 

 Thank you for calling. It’s been a pleasure speaking with you, have a great day!


100

If I am unsure if speaking to AI or the member, what should I do?

Ask

 Am I speaking to a live person?

Note:  Allow the caller or bot to respond.

  • If a live person is connected to the call; you may continue the call as normal starting with complete authentication.
  • If you feel that you are speaking to an AI bot, make three (3) attempts to get a live person on the line and wait 10 seconds between each attempt. If you determine a live person is unable to come to the phone inform the caller

 I am unable to continue the call without speaking to a live person. At this time, I will be disconnecting the call, please call us back when a live person is available

100

What is considered exceptional performance for Average ACW?

5 seconds and under

100

What does PBM stand for?

Pharmacy Benefit Manager

100

What is the name of the pet dinosaur on the TV cartoon "The Flintstones"?

Dino

200

What is the Account Wellness Check?

An account wellness check is when you view the member’s account for potential issues.  

 

200

Can we accept an Artificial Intelligence call to Authenticate a member?

No, make every attempt to get a live person on the call.  

200

What is considered unacceptable performance for Average ACW? 

50.01 seconds or more

200

What does DAW stand for? 

Dispense as written

200

Whitney Houston went to the top of the music charts in 1992 with which Dolly Parton song?

"I Will Always Love You"

300

What should you always make sure is up to date when speaking with a member? 

Verify phone and email address.

300

Are we allowed to speak to a live person initially then be transferred to provide information to AI?

No, we must always speak to a “Live” person when providing authentication, information or performing processes for our members.

300

What is the adherence to sign in goal for exceptional performance?

95% or higher

300

What does VQS stand for?

Verint Quality Score

300

What 2007 movie where a mild-mannered guy, who is married to a monstrous woman, meets the woman of his dreams, and schemes to find a way to be with her?

"Norbit"

400

What should you do if another prescription is available to fill?

Offer to fill the other prescriptions. Refer to 

Content ID : TSRC-PROD-054262 Compass - Mail Rx Refill/Renewal (Order Placement)

400

What happens if I am automatically transferred to AI upon answering the call?

Notify the caller that you cannot continue the call without a “Live” person on the call.

400

What is unacceptable performance for adherence sign in?

Below 80%

400

What does NPS stand for?

Net Promoter Score

400

In one of the most popular Dr. Seuss books, what won't Sam-I-Am eat?

Green eggs and ham

500

What do you cover when recapping a call? 

  • Include why the member called
  • The information you provided to the caller
  • What was done for the member and the turnaround time (i.e., New RX Request, EPA request, etc.).
500

What should you do if you have concerns about whether your caller is AI or a “Live” person?

Reach out to your supervisor.  

500

How can we improve member experience? 

Providing an outstanding member experience, ensuring accuracy of information, and striving to provide first call resolution.

500

What does ePA stand for?

Electronic Prior Authorization

500

In a website browser address bar, what does “www” stand for?

World Wide Web