Call Escalation Protocol
Initial Response
- Always attempt to authenticate account per HIPAA guidelines
- Take ownership and try to de-escalate: “I’ll be happy to escalate, but first let me authenticate your account and see if I can help directly.”
After Authentication
- Gather details: “To ensure I understand completely, could you explain what happened?”
- Offer to resolve: “I believe I can help resolve this for you. Would you allow me to try?”
- If patient agrees, take ownership and handle the call
Escalation Routes
If patient specifically requests “supervisor” or “manager” for a situation that is related to payment or because a statement has not been generated, follow these guidelines:
INN PTP Offered > Natera Billing Escalations
INN PTP Not Offered, NCS, SELF-PAY > Escalations L1
If patient specifically requests “supervisor” or “manager” for a situation that is NOT related to payment, transfer to Resolutions
Special Situations
If queue unavailable: Submit a “Patient Callback” ticket through Syncro CRM.
Critical Reminders
- Always warm transfer calls
- Resolution agents must not identify as supervisors/managers
- Always authenticate before escalating
Handling Calls in Resolutions
When a call is transferred from Billing to Resolutions, Resolutions agents must accept the call and work to resolve the issue to the best of their abilities.
Even if the call comes in directly (not a transfer), you are still part of the Resolutions team, and calls should be handled with the same mindset and professionalism as a Resolutions agent.
- Use all available resources, apply empathy statements, and acknowledge the caller’s concerns to improve their experience.
- Resolutions agents must take 100% ownership of the call and resolve it effectively.
Important
No Transfers Within Resolutions:
A Resolutions agent cannot transfer a call to another Resolutions agent, as both have the same tools and knowledge to address the issue.
De-Escalation and Escalation Handling:
If a caller escalates further, the Resolutions agent must make every effort to de-escalate the situation and take ownership of the issue.
If the situation remains unresolved despite your best efforts, transfer the call to Natera Escalations for further assistance.
Last update by: Nina O (Jan 9, 2025)