Handling emergency situations

1. Handling emergency situations

2. Handling emergency situations When assisting a member over the phone who is experiencing a dental emergency, we need to be prepared to handle the situation in a calm and professional manner. First and foremost, establish rapport as the person who can assist them with their emergency! Be reassuring and confident. Put yourself in their shoes. How rational and calm would you be if your son or daughter was in severe pain and face is swollen up? Would you be able to calmly and rationally describe the situation, or would you be upset and simply looking for the best help as soon as possible? Our job is to provide the highest level of customer care. So lets take a look at the steps involved in dealing with a member that is experiencing a dental emergency.

3. Goals • By the end of this course, you will: • Understand how to identify an emergency situation • Know what steps to take to assist • Be able to utilize proper soft skills while dealing with an emergency call

4. Remain calm and professional! Step 1: Identify Ask appropriate probing questions to assess the situation to the best of your ability. Your job here is to determine the next appropriate action, not diagnose their pain/dental emergency. You are not a dentist! Please do not attempt to diagnose the members pain. Suggested questions: “Do you need to go to the emergency room?” “Will you able to get to the dentist office if I can get you in today?”

5. Be the member advocate! Step 2: Contact and Assist Use your resources and locate a provider nearby. Then, call and attempt to establish an emergency visit for the member for the SAME DAY. You may have to contact several providers, that’s O.K. Keep the member on the line so they can describe their situation to the providers office if need be. Use positive reinforcement to assure the member their needs are of upmost importance. Suggested questions/statements: “Is there a dentist that you prefer seeing?” “Let me find a provider for you that will see you for an emergency visit.”

6. Be the member advocate! Step 3: Reassure the member This can be done by explaining any pertinent plan details that will solve their situation. Check their benefits and identify if they have an emergency dental benefit. This is not the first thing to do, as it is more important to identify if they are having an emergency situation. Suggested questions/statements: “You have an emergency benefit of “X”, so you will be taken care of at the dentist office.” “The important thing is to alleviate your pain and suffering. While there may not be a benefit available, lets identify the issue, stop your pain, and proceed from that point.”

7. Things to remember! The member comes first! We are a customer CARE team. Anyone can do customer service, but we are all customer CARE experts. We distinguish ourselves by going above and beyond to assist our members and providers. Finding a provider to help alleviate the members dental pain is priority! Regardless of whether or not benefits are available, pain is pain and it needs to go away! If the member is asking about their benefits in this situation, of course you are going to answer their questions. Our focus will be on the members well being, benefits or no benefits!

8. In conclusion • You should now: • Understand how to identify an emergency situation • Know what steps to take to assist • Be able to utilize proper soft skills while dealing with an emergency call

9. Course Complete! Please return to Quia to complete the course acknowledgement and quiz.