Chat Quality Audit
GEHA Scorecard — Chat Channel
Interaction Details
1. Member/Provider Experience
Max: 20 pointsProfessional greeting used
Actively engaged throughout chat
Expressed empathy through written response
Willingness to help conveyed
Professional and courteous language
Used member's name in chat
Used please and thank you
Correct grammar, spelling, and punctuation
2. First Chat Resolution
Max: 20 pointsAddressed all questions, issues and concerns
Included complete details specific to inquiry
Completed all actions needed for resolution
Set expectations/timeframes when applicable
Proactively offered options/solutions/next steps
Educated with relevant information
Asked probing questions (what/why/when/how)
3. Accuracy
Max: 20 pointsAccurate — Benefits
Accurate — Eligibility
Accurate — Network Status
Accurate — Prior Auth Requirement
Accurate — Medicare Coordination
Accurate — Claim/Pre-Determination
4. Policy and Procedures
Max: 15 pointsDocumentation
Check-in within 3 minutes of last response
Controlled chat direction, kept chat on track
Transfer/escalation procedures followed
Professional chat greeting
Additional Assistance Offered
Responded within SLA timeframe
5. Advocacy
Max: 15 pointsMention the G.E.H.A website
Member Advocacy provided
Offered additional resources if applicable
6. Security and Compliance
Max: 10 pointsVerified member identity appropriately
Provider FTIN/NPI verified
Reviewed ARF on file when applicable