If you have doubts about what type of scenarios you can use for each disposition, please follow the list below:
| Level 1 – Mandatory | |
| Inbounds & Outbounds | Description |
| Adjustment Request – RD Approval | Courtesy Exception approved to be used when is already in memos. Panam use only |
| Adjustment Request – ZBAL | ZBAL adjustments and patient calls back |
| Audit Test | Quality testing calls |
| Call Rejected | The patient declined or didn’t answer |
| Compassionate Care – Application processed | The patient was pre-approved, and an application submitted |
| Compassionate Care – General (no application processed) | Pre-qualification was done, and instructed patient how to apply |
| Courtesy Exception – Manager Escalation | Natera agents transferring to leadership – outside of walk-down parameters (To be used by Natera only) |
| Courtesy Exception – Successful | Natera agent was able to provide resolution according to walk-down parameters (To be used by Natera only) |
| Demographics Update (not insurance) | Updated the patient’s address, phone, and email |
| Escalated to Resolutions | The call was transferred to the Resolutions team |
| General Inquiry – Patient | Non-billing related calls. Can be used as well when the patient was given information on statement inquiries and payment options; however, patient has not yet decided and needs more time to consider. |
| Insurance – Appeals | An insurance company or patient calling about appeals |
| Insurance – Clm Resubmit | An insurance company or patient needing a claim to be resubmitted |
| Insurance – Clm Status | An insurance company or patient calling about the status of a claim, EOB explanation, etc |
| Insurance – Coding | An insurance company or patient calling asking for codes needed to process a claim |
| Insurance – General Inquiry | All inquiries from insurance companies (payors) |
| Insurance – Update/Changes | Insurance agent, patient, or authorized user calling to update Insurance information |
| InsuranceSelf Pay to INS Bill | Can be used when a patient decides to switch from self-pay to billing their insurance instead. |
| Itemized Statements | Patients requesting itemized statements or receipts |
| Panamericom Test Call | Testing calls |
| Payment – Full Pmt | statement balance paid in full or full PTP price |
| Payment – Link | Full payments or anything that is not a courtesy exception. |
| Payment – Missing | The patient called after a payment has been made and is still receiving statements we are requesting their proof of payment or the patient already made their payment and it’s posted in AMD |
| Payment – Partial | Walk down payments including Compassionate Care*Excluding courtesy exceptions* |
| Payment – Plan | The patient opted in for a payment plan. The billing rep guided the patient in setting up the payment plan |
| Payment – Plan canceled | Payment plan cancelled |
| Payment – PTP Payment | Patient paid the Price Transparency amount |
| Payment – Synergen Issue | Payment link issues |
| Payment – U-Contact Issue | This applies if the call dropped or if the patient never returned from the IVR system during the payment process. |
| Pending Synergen | Action pending Synergen, unable to provide resolution at this time |
| Pre-test Estimates | Pre-test estimates |
| PTP – Billing options provided | Patient received Price Transparency payment options |
| PTP – Case closed to insurance | After receiving Price Transparency payment options, patient decided to send the claim to the insurance |
| Refund request | The patient requested a refund and submitted |
| Req form request | The patient is requesting a copy of their req form – escalated to CSS |
| Test Status Email Provided | Non-billing related call – Managing Non-Billing Calls |
| Transfer – Advanced Pay | The patient is transferred to the advance pay team |
| Transfer – AMCA | The call was transferred to the offshore team |
| Transfer – AMCA Comp Care | Compassionate Care calls transferred to the Natera Onshore Team |
| Transfer – Billing | The call was transferred to the Billing team |
| Transfer – CFS | The call was transferred to the CFS (sales rep) line |
| Transfer – Courtesy Exception | Panam billing agent transferred to the Natera_Escalation campaign |
| Transfer – Customer Experience | The call was transferred to the Customer Experience team |
| Transfer – Natera Clinics | The call was transferred to the clinic’s line |
| Transfer – Natera Escalations | Escalations and Non-Courtesy Exceptions |
| Transfer – NCS | Panam billing agent transferred to Natera NCS campaign *Do not use* |
| Transfer – Prior Authorization | PA-related calls were transferred to the PA team |
| Transfer – Resolutions | The call was escalated to the resolutions team |
| Transfer – Signatera | The call was transferred to the billing Signatera team |
| Transfer – Spectrum | The call was transferred to the billing Spectrum team |
| Transfer – Supervisor | The call was escalated to a CSS (NOT resolutions team) |
| Transfer Natera NCS | Panam billing agent transferred to Natera NCS campaign *Do not use* |
| Unable to complete call – Patient ended the call | The patient disconnected the call |
Last update by: Claudia Fuentes (September 17, 2024)