Quality Assurance
- Michael Gaudette (Unlicensed)
QA audits are a way to ensure we are providing an excellent customer experience including:
Providing accurate information
Providing relevant information which customers should know
Reading all CMS required disclaimers
Treating each customer with respect
Below is the Scorecard and the QA Definitions Guide which outline exactly what the QA analysts are listening for and how scores are tallied.
Scorecard:
QA Definitions Guide:
Dropped Calls
If a call disconnects for any reason, all QA items must be restated for the recording on the inbound enrollment call to remain compliant. Prep the caller by stating something like “Please bare with me while I run through the compliance items. These must be stated again for the recording.”
Authorized Representatives
SOA
“Do you agree to discuss HMOs and PPOs, please say yes if you agree [capture “Yes” for the recording”
Plan Details
The following must be restated
Plan Name
Premium
Deductible
Application
If the app was already filled out on the previous call, run through all answers on the app. You may state them for the recording rather than asking the enroll again.
Payment Disclaimer/IRMAA
