Integrity Standard - Quality of Service

Policy:
We are committed to providing products and services of the highest quality and value to our customers. In providing our services, we will strive to provide prompt and accurate services consistent with contractual benefits, corporate policies, and regulatory requirements.

Our customers are the reason we are in business. We will serve them in a professional manner with integrity, honesty and respect.

We will pay all contractual benefits due Covered Persons and Providers promptly and accurately.

We will comply with all applicable statutes, regulations, and instructions that govern the administration of benefit programs.

We will continue to seek new approaches to increase the quality of service delivered to our customers while ensuring that it is delivered in a cost-effective manner.

Questions & Answers

Q: I work in customer service as a customer service representative (CSR). The CSR's are measured on their average speed of answer (ASA), which means "how long does it take to answer a call." I have heard that a co-worker answers a call, and then hangs up on the caller in an attempt to lower her ASA. Though I know it is wrong to hang up on a caller, I can see why the CSR feels pressure to do so. I am torn -- What should I do?
A: As Mr. McCaskey has stated "Pressure to succeed can never be an excuse for taking shortcuts that would compromise our integrity." Purposely hanging up on any caller violates every one of HCSC's Core Values and misrepresents numbers, which in turn can lead to misleading reporting. It is your duty as an HCSC employee to report such behavior. As with other concerns, report the issue to your Supervisor or another Corporate Resource.

Q. I overheard one of my co-workers being rude to a customer. When asked for his name, the representative refused to give it and disconnected the caller. Should I report this to my Supervisor?
A. Yes. Our customers are very important to us. We always want to serve them courteously. Your Supervisor will want to contact the customer, apologize, and address the customer’s concerns appropriately. Your Supervisor will also counsel the employee to prevent similar situations in the future.

Q. One of our large groups has a special benefit requirement that is difficult to understand. I continually hear customer service representatives give incorrect information concerning this benefit. I do not want to get anyone in trouble, but I am concerned that this may impact this group’s satisfaction with our service. What should I do?
A. Discuss this with your Supervisor and let him or her know your concerns. Additional training or one-on-one coaching may be needed to ensure employees have the knowledge and information needed to provide quality service.

Remember, if you do not understand, or if you have any questions concerning, this Integrity Standard or any other part of the Code, contact your Supervisor, a higher level Supervisor, any of the Corporate Resources or call the Corporate Integrity HOTLINE
(1 800 838-2552).

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