Oscar Health interview question

A member calls saying he/she has an appointment with an out of network doctor and is adamant about only seeing this doctor. How would you deal with member?

Interview Answers

Anonymous

10 Aug 2019

Acknowledge: let the member know that you understand what they are asking for. Repeat their request. Then follow up with questions to get more information. Have you been to that doctor before? Do you have a history with them? Are they a specialist that is an expert in something you need help with? Align: make sure that once you have the above information, they know that you understand what their concerns are and that you are on their side. Repeat the details of what you learned, and add affirming statements such as, “because [insert info from above] you feel like you are going to get better care.” In this way they know that you are aligned with their goals. Assure: now that you have a better understanding, and they know that you are on the same page as them, assure them that you will do everything in your power to help. This may mean discussing payment options that might be a bit more expensive or discovering peers in net work that are cheaper. The point being that you will work hard to explore all the options available, so that they can make the best decision possible for themselves.

Anonymous

24 Nov 2015

Offer member to see another doctor who is in network and has good ratings.