Notes

PST DAY 1
Analyst: They will analyze the calls


House rules:

1. English Only Policy

2. Clean desk Policy / Electronic Notepad Only

3. One Mouth Policy / Use chat pad if you have questions

4. No food inside the production floor

5. Schedule adherence (You should never be late)

6. Bio Break (Only on person at a time is allowed to step out)

7. Don't go inside the training room without trainer

8. No sleeping inside the training room

9. Limit all distractions (Avoid unnecessary conversations)

10. PC settings should not be changed

11. No gadgets allowed

12. Personal belongings (Put everything in the locker)

13. Do not access non work related sites

14. Dress Code

15. Task Completion (Finish tasks on time)

16. Respect is a must ( Be careful with your jokes)

You should notify trainer that you will be absent or late

It's very important to MASTER THE CALL FLOW

Phonetics:

Alpha

Bravo

Charlie

Delta

Echo

Foxtrot

Golf

Hotel

India

Juliett

Kilo

Lima

Mike

November

Oscar

Papa

Quebec

Romeo

Sierra

Tango

Uniform

Victor

Whiskey

X-ray

Yankee

Zulu

6 TIPS IN BUILDING RAPPORT

Remember member's names

Find common ground

Actively Listen

Ask Questions

Mind your body language

Reserve judgement



PROTECTED HEALTH INFORMATION (PHI)

Names, Phone Numbers, Account Numbers, Social Security Numbers, Geographic, Fax Numbers, Medical records, All element of Date, Email address, Health Plan beneficiaries, Vehicle Identifiers, Certificate and License Numbers, Urls, IP address, Biometric Identifiers Fingers or Voice Prints, Full Face Photographic Images, Unique identifiers characteristic or code



Member Journey (Enrollment, Onboarding, Building Relationships, Access to care, Quality of care, Care coordination, Billing, and Member Feedback)



Member journey maps help health insurers better understand member interactions. They can provide insights into what members think of health insurance interactions, help you identify low-performing interactions, and create a more member-centric approach.



First Phase (Pre Member)

-Discovery of the brand (Recommendation, Advertisement)

-Seek advice on what product and policies whould suit them best.

-Quoting a phase where members make a decision on what insurance they would choose.

-Bind with the insurance company through a contract or subscription

Second Phase – Pay Premiums, Manage, Make Claims and Renewal/Retention.

-Pay Premium – Once binding has been completed the member will start paying the premium.

-Manage – The customer will be required to update personal details that would be used later to verify the member's eligibility for coverage.

-Make Claims - An insurance claim is a formal request from the policyholder (that's you) to their insurance company asking for payment after a covered incident.

-Renewal/Retention -Keep the customer and turn them into a promoter of the company.

Caller Types:
-Authorized Rep.
-Deceased Member
-Employer Group
-Internal Caller
-Member
-Power of Attorney/Guardian/Conservator
-Provider


Insurance – protects against financial losses.

Disability Insurance – protects the income of the insured when unable to work.

Property Damage Insurance – Protects the insured against losses incurred due to property damage.

Auto Insurance – Protects the insured against losses incurred due to automobile accidents.

Life Insurance – Protects the beneficiaries of the insured in the event of the insured's death.

Vision Insurance – Provides coverage for routine eye care.

Dental Insurance – Provides coverage for routine dental care or dental care or dental care not covered under health insurance.

Health or Medical Insurance

Health insurance – covers medical and surgical expenses.


PHI Identifiers: Names, Phone Numbers, Account Numbers, Social Security Numbers, Geographic, Fax Numbers, Medical records, All element of Date, Email address, Health Plan beneficiaries, Vehicle Identifiers, Certificate and License Numbers, Urls, IP address, Biometric Identifiers Fingers or Voice Prints, Full Face Photographic Images, Unique identifiers characteristic or code