script of how we offer second opinion CRITERIA

-Check If work order has been authorized -Check if the member's request is within 7 days, starting from DAY that the mbr was md awr of the diagnosis. -Seek approval from your Supervisor -Advise the member the 2nd guideline   - "The options that we have is the second opinion. We will send a second company which can go out and diagnose your unit."   - "I'd like to make you aware that when the second company reports that their diagnosis is the same as the first diagnosis you will be required to pay an additional service fee. However if they are not the same, no additional charges due." -Members must agree with the guideline. -Process 2nd

                     Customer Requested Second Opinion Criteria

• A second opinion can be offered if the dispute is over the diagnosis only.

• Review contract language prior to offering a second opinion.

• Verify AHS has received the diagnosis and cost from the first contractor.

• Ask questions to verify the customer's dispute and validate that the customer understands the autho decision and why the contract supports that decision.

• The second opinion requested by the customer should not be entered into the system until the customer has been made aware of an agrees to the possibility of an additional trade service call fee, if the second opinion service contractor concurs with the first service contractor. (See the required scripting below.)

• Some contracts state that the customer’s request for a second opinion must be made within seven (7) days after AHS informs the customer of the coverage decision or that a malfunction of a covered item is not covered by the contract.

• If the customer’s contract states they have the right to request a second opinion, then AHS must locate a contractor to provide a second opinion. In these instances, the service contractor does not have to be a call committed (preferred) vendor.

• If the customer’s contract does not specifically state it allows customer requested second opinions, then AHS will only provide a second opinion if a call committed (preferred) service contractor is readily available to be dispatched. Exception: CA Customers have the right to a second opinion regardless of their contract terms and regardless of whether a preferred contractor is available or not.

                                       Additional Guidelines
  

• A second opinion should be honored on expedited requests for any CA customer or customers with contracts that say they have the right to a second opinion. If the original service request was expedited, then you should also service the second opinion as an Expedited Service Call.

• Do not enter a second opinion as a Transfer Vendor. If the dispatched second opinion contractor cannot service the item that was dispatched to them as a second opinion, please place a new second opinion work order in the system, and do not enter a Transfer Vendor.

• AHS will not perform a third opinion.

• Always be sure to inform customers that obtaining the second opinion may cause a delay in their service.

• A second opinion is not an option if the customer is disputing non-covered costs, cash-in-lieu amount or the type of service they received.

                             SECOND OPINION CRITERIA
  

• Check If work order has been authorized -Check if the member's request is within 7 days, starting from DAY that the mbr was md awr of the diagnosis. -Seek approval from your Supervisor -Advise the member the 2ndd guideline

• "The options that we have is the second opinion. We will send a second company which can go out and diagnose your unit."

• "I'd like to make you aware that when the second company reports that their diagnosis is the same as the first diagnosis you will be required to pay an additional service fee. However if they are not the same, no additional charges due." -Members must agree with the guideline. -Process 2nd -Click Second Opinion

Click homeowner Homeowner requested Call vendor - to make sure that vendor can complete it wwithin 48 business hrs.

Customer Called In  Mbr Uriel Edwards (BUYER) called in to req 2ndd since he is disputing the initial diagnosis. Md mbr awr 2ndd was assigned to Greenway Home Services, dispatch #450435047 and office # 9013819001. Advise that when the second company reports that their diagnosis is the same as the first diagnosis they will be required to pay an additional service fee. Mbr ok (approved by SUPV Atabigue)

                             Second Opinion Outcomes
                   Second Opinion Outcome Is The Same

• In the event the outcome of the second opinion is the same as the first opinion, AHS will charge the customer a trade service call fee for the second opinion if their contract allows.

• Second Opinion Outcome Is Different

In the event the outcome of the second opinion is NOT the same as the first opinion then AHS:

• Will make a coverage decision based upon a prompt, thorough and objective investigation including assessment of the first and second opinions.
• Will decide between the opinions based upon the investigation. Regardless of who performs the service work, there is no trade service call fee due on the second opinion service request.

second Opinion - if they are both authorized. they dont pay - offer cash in liue

• If the mbr have existing wo - offer cash out If the job has not been completed - do not offer cash in liue