Chat training

Introduction to chats

Competencies

This is what you should know to become chat HCC:

 

Chat flow

All kinds of chats should have this flow:

1. Onboarding and understanding the customer's need.

2. Taking fulfillment/Helping with original need.

3. Adding value on top of original need.

Onboarding

1. Greeting canned text. Do not write your name!

2. Check insurance information in CRM. 

  • If there is no insurance information check info in BO or #hcc-chat-handoff group. Verify it with the customer and then verify it in Houston.
  • If there is an insurance added, but it's not verified, verify it with the customer and then in Houston.

3. Review the list of the previous tickets and chat history if needed.

4. If you are unsure what type of provider the user is looking for, ask an additional question. Understanding customer needs is core important.

Taking fulfillment: Dental/Vision

Taking Fulfillment - Dental/Vision

1. Ask the reason for the visit.

2. If the customer has a preferred provider, check verify the address.

3. Check if major medical insurance covers dental services.

4. If the member says that he/she has a dental insurance, in most cases they mean a dental discount through our subscription. But you still need to check in BO and #hcc-chat-handoff if there is any dental insurance. 

  • If the member has a standalone dental insurance, explain that we can't check the benefits and locate providers for dental insurances. Provide the member with an insurance carrier phone number to call. Explain why a dental discount is better and offer to find a dental provider who is in-network with our discount program. 

5. It's always great to explain how mention discount name and the percentages of a discount. There is a great canned text for this. 

6. Set expectations and create a ticket.

Taking fulfillment: PCP/Specialist

Taking Fulfillment - PCP/Specialist 

1. Ask the reason for the visit.

  • If it is appropriate for the telemedicine, push telemedicine. 

2. Ask the gender preference. 

3. If the customer has a preferred provider, check verify the address.

4. Set expectations and create a ticket.

Adding value

After we helped the customer with the original need, we need to offer additional service to add more value to the chat. 

The list of the services that we push in descending order:

  1. Telemed

  2. Rx discount/Rx review/pill pack

  3. Claims management

  4. Provider

  5. Benefits

Provider Chat flow example

Member: Dentist

E.M.M.A.: Your Healthcare Concierge has been invited to help!

HCC: Hi, Member.
I'm your Healthcare Concierge. Give me one moment while I look up your profile.

HCC: As I can see, you have Anthem HealthKeepers Silver X 3350 15 plan from BCBS, is it correct?

Member: Yes

HCC: Thank you for confirmation.

HCC: Is there a specific reason for a dental provider visit or it's just for the future?

Member: Need a cleaning it’s been over a year

HCC: Thank you. And do you have the preferred doctor?

Member: No one particular

HCC: Thank you for clarification.

HCC: We will locate dental provider in your area who is in network with your membership plan. Request processing times vary depend on volume. Most non-urgent requests are completed within one week. We will follow up with you online.

HCC: Please keep in mind that your dental discount is provided through Careington POS. This is a dental discount network, not insurance. Discounts vary between 20% to 50% off, depending on the procedure.

Member: Ok

HCC: I also want to remind you that our team of on call doctors is available 24 hours a day. Simply click the "Doctor Consult" button on the upper right corner and request a call by one of our Board Certified physicians.

Member: Well, I have a sore throat. Can your doctors prescribe me something? 

HCC: Sure. Phone consultations are at no cost to you. Simply click on the Doctor Consult tab on the right hand corner above to get started.

HCC: Chat us back with the name of the medication that will be prescribed and we will help you to save money on it.

Member: Great! Thank you for your help.

HCC: You are welcome. Is there anything else I can assist you with?

Member: Not right now.

HCC: Get instant access to your Membership Card, discuss your plan benefits, or get medical advice anytime from your GoHealth Access mobile app. Your Healthcare Concierge is joyfully just a few fingertips away.

Rx Chat

HCCs should be automatically submitting Rx Review tickets anytime they recognize that a customer is either:

  • Taking an expensive medication, or
  • If the customer takes multiple medications that are not already at the lowest cost

If a customer chats you looking for medication discounts and they take multiple medications or expensive ones, give them the discount codes, and then you should create a Rx Review ticket and let the customer know that one of our doctors will review their medications in order to try and save them money. 

Rx Review ticket can be created if HCC has at least medication name and insurance is verified.
Additional information for Rx Review ticket that should be obtained:

  • dosage
  • frequency of use
  • condition
  • preferred pharmacy

All information, that you get in chat must be added in Health Assessment tab in Houston.

Rx Chat flow example

Customer: Oxymorphone. Er

E.M.M.A.: Your Healthcare Concierge has been invited to help!

HCC: Hi, Mike. I'm your Healthcare Concierge. Give me one moment while I look up your profile.

HCC: You don't have any major medical insurance plan. Is it correct?

Customer: That's correct just the discount for prescription

HCC: Thank you for clarification.

HCC: Can you please specify the dosage of the medication?

Customer: So when I go to Walgreens and pick up my medication, do I tell them I have a discount service and tell them it's go health?

Customer: The menu icon?

Customer: It is oxymorphone Er 30mg for 60 count per month

HCC: At first we will locate for you the best price for medication, and than we'll provide you with all necessary information how to get your medication.

Customer: I am waiting for a prescription at Walgreens right now

HCC: The discounted price for oxymorphone ER 60 tablets 30mg is $283.44 at Walgreens. (775) 297-6725 - is it a good phone number to send you the discount codes?

Customer: Yes it is

HCC: Okay. I have texted ou the discount codes.

HCC: Also, our team of doctors can will review your medications in more detail to look for additional ways to save money.

Rx_Optimization_Example.pdf

HCC: We will contact you when your Medication Optimization Report is complete. Request processing times vary depend on volume. Most non-urgent requests are completed within one week. If you are logged in our mobile app, you will receive an instant notification when the report is complete.

Customer: What company was the discount through

HCC: This discount is provided by one of our partners.

HCC: You will just need to show the codes at the pharmacy in order to get a discount.

HCC: As a reminder, your subscription to GoHealth Access gives you access to our team of board certified doctors available by phone 24/7 to provide advice, prescription assistance and treat common conditions. Set up a consultation by selecting the "Talk to a Doctor" button or the icon in the upper right of your screen.

HCC: It is convenient and you can save money on the doctor visits. Because the price for uninsured patients usually starts at $100.

HCC: Is there anything else I can assist you with?

Customer: No, that’s it

HCC: Get instant access to your Membership Card, discuss your plan benefits, or get medical advice anytime from your GoHealth Access mobile app. Your Healthcare Concierge is joyfully just a few fingertips away.

General chat advices

1. Do not guess. Ask questions in chat if you are not sure what is the customer's need.

2. Do not write long sentences. Short replies = short wait time.

3. Do not use too many canned text.

4. Edit canned text to make it personalized.