Email Quality Audit
GEHA Scorecard — Email Channel
Interaction Details
1. Communication Quality
Max: 20 pointsUsed correct email response template
Complete sentences, correct grammar, spelling, punctuation
Professional and courteous tone
Clear and easy to understand response
Personalized response (not purely canned)
2. First Contact Resolution
Max: 20 pointsAddressed all questions raised in email
Included complete details specific to inquiry
Completed all internal actions for resolution
Set expectations/timeframes when applicable
Proactively offered options/solutions/next steps
Educated with relevant information
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 — calltrak entries complete
Responded within 24–48 hour turnaround
Correct Originator/Caller Type used
Correct Doc Type and Inquiry Status
Entered under correct patient/member
Captured all pertinent information
5. Advocacy
Max: 15 pointsMention the G.E.H.A website / portal
Member Advocacy provided
Offered additional resources if applicable
6. Security and Compliance
Max: 10 pointsAppropriate member verification for email channel
No PHI exposed inappropriately in email
Reviewed ARF on file when applicable