We work with patients and customers who are confused or upset about their medical insurance. Tell me about a time you had to teach and train an upset customer. How did you handle the situation and what was the outcome?

How to Answer
1st Answer Example
2nd Answer Example
Community Answers

Health insurance can be very complex to the average person and the interviewer wants to know if you can handle a person who is very upset. Show that you care about each caller and that you have empathy for that individual. Showcase your problem solving skills and the fact you can handle a high degree of emotion on the phone without getting rattled, still helping the customer, and trying to get them what they need.

"I had a caller the other week who was crying because her insurance didn't cover a procedure that she had a month prior. She was very upset and stated that she couldn't afford to pay this bill. I let her talk without interrupting her and listened. I repeated back to her what the issue was to make sure I understood her correctly. I took her information down and looked up her account to see what her insurance covered. I discovered that our insurance did cover 80% of the procedure, but she had to pay for the other 20%. Through further conversation in a calming voice, I was able to tell her that insurance did cover a big portion of the procedure and gave her the number of the financial assistance office at the hospital to see if they could put her on a payment plan for the remaining portion. I knew from my experience that most health care systems offer this. She sounded relieved and grateful when we hung up and thanked me for my help."

"I had a caller who didn't know what his statement meant- he said all of the medical terminology didn't make sense to him. I wrote down his questions and then pulled up his statement and walked him through each part so he understood the statement. He actually didn't have any payments he would be responsible for, so he was very happy. He didn't know this until I took the time to walk him through the statement. He thanked me at the end of the call."

Anonymous Answer

"Patients are already dealing with so much regarding their healthcare. The last thing they want is the burden of medical insurance and costs. When dealing with a patient who is upset, I would handle the situation by firstly, listening to what the patient has to say and letting them know, that I hear their concerns and I am only there to be of service to them and help them. Once I am able to understand their frustration -I can then find a solution. A recent patient of mine wanted their health information to be sent to the VA so this person can receive benefits. Yet, the documentation was not complete yet by clinical staff as this person was just seen a few days prior. This upset the patient as they are eager to confirm benefits from the VA. They are not aware of the turnaround times that clinical staff has to complete documents. I sat down with the patient and ensured that - that I will do my part to contact the staff- make it a priority to have the documents completed as well as follow up with the patient when I know this request has been completed."

Amanda's Feedback

You've chosen another strong example that illustrates your ability to provide exceptional service even in a difficult situation. You can finish this answer more thoroughly by sharing how the situation ended. Did you prioritize the documentation? Did you follow up with the patient? Was he or she satisfied with your efforts to meet their needs in the end?