General Policies for Inbound and Outbound Calls

Submitted by admin on Tue, 05/04/2021 - 15:37
Policy: 

In implementation of Fiscal/Employer Agent services for the participant direction program, F/EA seeks to empower consumers to manage their services. 

F/EA <<Customer Service Representatives>> are available at the toll-free phone number to respond to <<participant, representative and workers>> inquiries from <<9AM to 5PM>> on all non-state Holiday business days.
 
<<Staff Title>> communicate only with consumers or representatives.>>  <<Staff Title>>s do not provide information to or respond to inquiries from workers or other participant stakeholders. All written and verbal communication performed by <<Staff Title>>s is conducted with consumers or representatives.>>
 
Policies and procedures in this document are general in nature.  Specific policies and procedures apply to certain other Customer Service responsibilities and can be found in other Policy and Procedure documents. All non-routine inbound and outbound calls are logged in Customer Service System per Policies and Procedures. Specific policies and procedures apply to resolving timesheet discrepancies as documented in <<>>. Written communication with consumers is documented in Policy and Procedure document <<>>. 
Procedure: 

Inbound Calls

  1. <<Staff Title>> (or assigned staff) answers inbound call to F/EA toll-free number
  2. <<Staff Title>> states:
  •   “Thank you for calling <<F/EA>>. How can I help you?”

  3.  <<Staff Title>> listens to brief description of nature of call

  4. <<Staff Title>> asks the caller if they are the participant or representative.>>

  5. <<The below section may not apply if program does not have restrictions on F/EA speaking with stakeholders other than consumers and representatives>>

  6. << If the caller says “no”, <<Staff Title>> explains that F/EA can only speak to the participant or representative about Fiscal/Employer Agent matters>>

  7. <<If necessary, <<Staff Title>> explains that F/EA is not the employer of the workers, but rather that the participant or representative is>>

  8.  <<Staff Title>> reminds the caller to contact the participant or representative with any questions, and if necessary, the participant or representative can contact F/EA>>

  9.  If the caller states that they are the participant, <<Staff Title>> asks the caller for his/her name

 10. Verify that the participant exists in the program

 11. Log into Customer Service System

 12. Search for participant by name

 13. If participant exists, open participant record

 14. Record information about call per in Customer Service System for Consumer Record

 15. If participant does not exist in Payroll System, get more information from caller about why they are contacting F/EA

 16. <<If the caller states that they are the representative, ask the caller his/her name

 17. Ask the caller the name of the participant for whom they are the representative

 18. If the representative name matches F/EA records for participant, proceed with call>>

 19. <<If the representative name does not match, inform the caller that they are not listed as the representative and that F/EA can only communicate with representatives and consumers

 20. Inform the caller to contact the representative or participant

 21. If necessary, provide the caller with the name of the representative listed

 22. Do not provide additional information to the caller who is neither the representative nor representative>>

 23. <<Staff Title>> proceeds with call.

 24. Information is provided as applicable

 25. If additional research is required, <<Staff Title>> provides caller with an estimated time when <<Staff Title>> will contact caller with research

 26. For specific types of calls, see “Respond to Consumer Inquiries” Policy and Procedure document

 27. Document caller issue, caller name, and resolution in Customer Service System per Policy and Procedure X.X

 
Outbound Calls
  1. Prior to making an outbound call, <<Staff Title>> verifies if the participant has a representative
    • <<Staff Title>> Opens Customer Service System
    • After finding participant in system, scroll and review the representative contact information
    • Contact the representative at the phone number listed
    • If a representative name is not listed, contact the participant at the phone number listed

  2.  Collect all applicable information and place call

  3.  If phone is answered, state: “This is <<name>> from F/EA. Is <<participant or representative>> available?”

  4.  If participant or representative is available, discuss issue

  5.  If participant or representative is not available, ask to leave a message with the person who answered the phone

  • Request that the participant or representative contact F/EA at <<toll-free number>>
  • Do not provide additional information on the issue as data and information is confidential

  6.  If a voicemail system is reached, state:

  • “This is <<name>> from F/EA calling for <<participant or representative>>. Please call us  at <<toll-free number>>.

  7.  Record the communication in Customer Service System

Internal Controls: 

The internal controls used by F/EA to monitor this process establish responsibility, segregate duties, document procedures and ensure independent internal verification.

  1. All communication with callers is recorded in Customer Service System per Policy and Procedure document X.X
  2. Prior to providing any information during an inbound call, <<Staff Title>>s verify that caller is participant or representative
    • <<Staff Title>> matches caller’s name to participant or representative name in Customer Service System
    • If names do not match, <<Staff Title>>s request that caller contact participant or representative
    • <<Staff Title>>s do not provide information to callers who are not consumers or representatives
  1. Prior to placing an outbound call, <<Staff Title>> verifies if participant has a representative
    • If participant has a representative, <<Staff Title>> requests to speak with representative
    • If participant does not have a representative, <<Staff Title>> requests to speak with participant