Telephone standards for Medicare and Health Delivery 011-40120020

• Always adhere to scheduled phone time
• Be familiar with the telephone equipment and the system being used

Service Officers are to use best practice elements to greet a customer when answering phone calls.

Examples of best practice greetings are:

• 'Hello, this is [Service Officers name], can I start with your name please?'
• 'Hi, my name is [Service Officers name], may I start with your reference number (Medicare card number, Provider number etc) please?'
• 'Hi, this is [Service Officers name], how can I assist you today?'
• 'Hello, my name is [Service Officers name], how can I help you today?'

Note: using a greeting, when answering phone calls, ending with the word 'speaking' is an inappropriate greeting. For example, staff should not state 'Hello Sarah speaking' as this is not a correct greeting protocol.

Staff must:

• be certain the record they are accessing belongs to the person making the enquiry, or they are the authorised representative
• not give out any information unless authentication processes are completed successfully

To make sure the privacy of the customer is maintained follow Privacy concerns when calling customers, returning calls or leaving messages on answering machines when contacting a customer or actioning callback.

The Resources page contains a link to the Authenticating a customer sub-site which contains links to relevant Medicare Operational Blueprint files

Service Officers should not provide their Logon ID or P number as a receipt of confirmation of an interaction. See the Resources page for a link to personal security guidelines.

Service Officers:

• manage emotions during calls
• recognise and manage complaints
• are assertive
• offer alternative communication channels to callers
• promote the digital strategy as appropriate to the call. See the Self Service index for support
• can ask the customer/provider to note the date and time of call and provide the caller with their first name as receipt of interaction

Before placing the customer on hold:

• Explain why and offer alternatives
• Ask the customer for permission e.g. 'do you mind if I place you on hold while I [reason for hold]? I'll be back with you in about [estimated time] minutes'

If the customer needs to wait on hold for longer than the estimated time, tell the customer of the new time frame e.g 'thank you for your patience, I am still working on your record. I'll be back with you in about [estimated time] minutes'

Thank the customer when they come off hold: 'thank you for your patience', or ‘thanks for waiting/holding'

The Resources page contains a link to the Staff Feedback Tool.

The 'Mute' facility on a phone is useful for times when it may be necessary, for example, to cough or sneeze during the conversation. Use mute for short periods only.

Staff may need to speak to a third party over the phone initiated by the caller ‘in' the call or put the third party on speaker. Refer to Call and screen recording – information and access regarding third party calls.

Staff must:

• make sure the individual has consented to the disclosure to the unrelated third party
• document on the individual's Medicare record:
• that customer initiated the involvement of the third party in their call
• customer's consent and details to reflect the consent in this one-off occurrence
• make sure the call recording privacy script is read and agreed to when the third party joins the call

When a call gets disconnected during interaction with external stakeholders:

• if the customer is disconnected during a call, or while transferring or while on hold, attempt to re-contact the customer
• in an event of unsuccessful attempt to contact the customer, make sure to record call details in the relevant systems where it permits

Do not make assumptions about a person's gender identity based on indicators, such as their name, voice or appearance.

If after performing security checks the customer is successfully authenticated, continue with the enquiry.

If the customer is not successfully authenticated, the customer must:

• call back at another time with more information, or
• attend a Service Centre with an approved photographic identity document

If staff are concerned the person is not the owner of the record:

• see Step 2 in the Health suspected fraud and corruption table, or
• complete the authentication process for the relevant Program. The Resources page contains a link to the Authenticating a customer sub-site

To make sure the privacy of the customer is maintained follow Privacy concerns when calling customers, returning calls or leaving messages on answering machines when contacting a customer or actioning callback.

Staff may need to make outbound calls to members of the public, medical providers, and authorised third parties.

Staff are to:

• avoid making outbound calls before 8 am or after 8 pm (local time for the member of the public or provider). The Service Officer's business line may need to raise proficiency of a work item so that staff working during normal contact hours can attempt customer contact
• only make one outbound contact attempt within a 24 hour period. However, if the situation is urgent or needs an immediate response, staff may continue contact attempts via phone for as long as necessary
• complete the appropriate level security check for the call type being performed. The Resources page contains a link to the Authenticating a customer sub-site

Receiving returned outbound calls

When a member of the public or the provider responds to a message left on an outbound call, Service Officers must follow the security check guidelines to confirm the caller's identity.

Note: assure the caller that the security check is to verify their identity and prevent information being disclosed to someone else.

If a customer is aggressive or abusive during a call, Service Officers should remain calm.

Explain to the customer:

• the call will be terminated if they continue to be aggressive
• the agency expects its staff to be treated with respect and courtesy
• it is difficult to help when a customer is not acting appropriately

See Customer aggression - Prevention and management.

De-escalation techniques can reduce verbal aggression. Staff should:

• be non-judgemental
• empathise
• use positive phrasing
• acknowledge the customer's feelings when answering sensitive questions
• use a calm, gentle and soft tone of voice with shorter, rather than longer sentences
• avoid ultimatums or threats
• attempt to find things they can agree on with the person
• role model the behaviour they would like the person to display
• avoid feelings of anger or personal offence
• practice active listening. This makes the person feel that the staff member is committed to understanding their situation

The customer may not be able to effectively hear or understand when they are distressed. Staff may need to:

• repeat key information
• refer the call to their team leader and discuss appropriate escalation procedures

If the customer persists with aggressive or counterproductive behaviour after being warned, tell them that the call will be terminated.

Team Leaders should make sure that Service Officers are given support after handling an abusive or aggressive call. This includes:

• time to debrief and recover away from the general work area if needed
• offering access to employee assistance programs
• advising staff of their responsibilities under the APS Values and Code of Conduct

See the Aggressive behaviour response model.

All incidents of aggressive behaviour must be recorded in Customer Incident Management System. To report and record an incident. See Customer aggression - Reporting and recording incidents.

If the customer has made threats see the Responding to virtual threats to harm staff or damage agency property table.

De-escalation may not work and staff may need to disengage and terminate the call. To terminate the call:

• warn the customer the call will be terminated
• thank the customer for calling by using a suitable phrase e.g 'thanks/thank you for calling, goodbye/bye'
• summarising the call and checking for understanding with the customer

Terminate the call using Services Australia Workspace.

If a customer phones Services Australia and places the call on 'hold', e.g to take another incoming call, or leaves their telephone unattended, allow 30 seconds for the customer to come back to the call.

If the customer wishes to place the call on hold

• tell the customer their call will be terminated if they do not return within 30 seconds
• and does not return within that time the call should be terminated and the customer will need to call back

If the caller:

• already has the Service Officer on hold before speaking with them, allow 30 seconds for the customer to return to the phone. If the caller does not return in that time, terminate the call
• does not return within that time the call should be terminated and the customer will need to call back

Exception for PBS Program only: Service Officer does not need to wait 30 seconds before terminating the call where the caller leaves the phone unattended.

A member of the public may advise or have concerns personal records/identity have been compromised or accessed:

• If a privacy breach is suspected or reported see Identity fraud
• If a scam is reported, see Advice of a scam or theft or loss of personal information

The Scams and Identity Theft Helpdesk can also provide support and advice if a scam has been detected.