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Thank you for calling Horizon Blue Cross Blue Shield of New Jersey.
My name is (First Name) . How can I help you today?"
"Emotion: “I understand how upsetting it can be when your claim is denied and you have had to make several calls attempting to have this issue resolved.”
No emotion (blended with ‘I can’): “I’d be happy to look into the claim and advise of what can be done with it."""
"“I can help you resolve this claim issue”
“I would be happy to help with checking the benefits today.”
“I can” combined with an acknowledgement of issue:
“I can provide you with that eligibility information.”
"Situation questions (These are short, closed-ended questions that give you quick facts, or yes or no answers. )
*Verify the Provider Information:
- May I have your Tax ID number? (or their NPI as an alternative)
- Can you verify to me the name of the practice/office?
- May I have your name and phone number? (no need to ask for the full name)
*Verify the Patient Information:
May I have the:
- ID number
- Patient's name
- Date of birth
(refer to CC5 - Validated HIPAA)
"Refer to the info kit
Examples:
“I would be more than happy to review the patient's benefit information now or you can access your account at Navinet.net and review that information at your convenience.”
"“Are there any other questions for me today?”
“Is there anything else I can help you with?”
Provide/offer the reference number:
""Here is your reference number for this call:
(each call has unique LVP#, sample: LVP-123456 (NCompass is primarily being used); Secondary UCSW SR# 1-9115958224U)
Thank you for calling Horizon Blue Cross Blue Shield of New Jersey.
""I will be connecting you to a post call survey that rates your experience with me today since I am the last person you spoke with. """
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