Red Flag Identification and Escalation Guidelines
Evaluate Each Scenario Individually: Every case is unique, so assessing and escalating is important.
Conduct Thorough Research: Take the time to investigate the case in detail. Reach out for clarification or additional information if needed.
Validate All Escalations: Ensure all escalations are legitimate and meet the required criteria before submitting them.
Trigger Words
In cases involving the following keywords or scenarios, take immediate action:
Legal action, Attorney, BBB complaint, State Law, Court, Social Media, Bankruptcy, Fraud, Scam, any legal threat, CEO, file a complaint.
Action Steps: Immediately warm transfer to Natera Billing Escalation Calls-650.412.8715- and submit an “Executive Escalation Keywords” through Syncro CRM to ensure proper tracking and follow-up.
Reminder: Always empathize and advise the next steps
“I understand this situation may be stressful, and I want to make sure it is handled by the appropriate team right away. I’m going to transfer your call to the next level of support so they can address your concerns as quickly as possible.”
Repeated Callers
A caller is considered a repeated caller if they have contacted us three or more times regarding the same issue, whether through phone or email.
How to Identify Repeated Callers: Review notes in LIMS or AMD to confirm previous contacts. Pay attention if the caller mentions they have reached out multiple times.
Action Steps: Immediately warm transfer to Natera Billing Escalation Calls-650.412.8715- and submit a “Patient SOS” through Syncro CRM to ensure proper tracking and follow-up.
Reminder: Always empathize and advise the next steps
“I understand that you’ve already reached out about this, and I apologize for the inconvenience. Let me escalate this to the next level of support so we can ensure a quicker resolution for you.”
Recognizing Caller Frustration
Frustration isn’t always expressed through raised voices. Be attentive to these signs of frustration: References to waiting for a follow-up. Statements about expecting a response. Expressing urgency or needing an answer.
Action Steps: Immediately warm transfer Natera Billing Escalation Calls-650.412.8715- and submit a “Patient SOS” through Syncro CRM to ensure proper tracking and follow-up.
Reminder: Always empathize and advise the next steps
“I completely understand how frustrating this must be for you. I want to ensure we address your concerns promptly. Let me transfer your call to the next level of support so they can work on resolving this issue as quickly as possible.”
Trigger Words
If an email contains any of these words, take immediate action:
Legal action, Attorney, BBB complaint, State Law, Court, Social Media, Bankruptcy, Fraud, Scam, any legal threat.
Action Steps: Immediately transfer the ticket to the “Bill Review” queue. Include a detailed chatter post explaining the reason for the escalation to ensure proper follow-up and resolution.
Repeated Contacts/Interactions
A contact is considered a repeated contact if they have contacted us three or more times regarding the same issue, whether through phone or email.
How to Identify Repeated Callers: Review notes in LIMS or AMD to confirm previous contacts. Pay attention if the caller mentions they have reached out multiple times.
Action Steps: Immediately transfer the ticket to the “Bill Review” queue. Include a detailed chatter post explaining the reason for the escalation to ensure proper follow-up and resolution.
Do Not Contact Me
When a patient states they no longer wish to be contacted by Natera, escalate the case by submitting a “Do Not Contact Me” ticket through Syncro CRM.
This applies when a patient explicitly requests not to receive calls, messages, or printed information from Natera.
This scenario is uncommon, as patients are given the option to opt out of communication when they sign the requisition form.
Action Steps: Submit a “Do Not Contact Me” ticket through Syncro CRM to ensure proper documentation and follow-up.
Reminder: Always empathize and advise the next steps
“I understand your request, and I’m sorry for any inconvenience. I’m going to escalate this to ensure that your preference is honored and you’re no longer contacted by Natera.”
Please refer to: Handling “Do Not Contact Me” request
Last update by: Nina O (Dec 18, 2024)