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A member calls Aetna complaining about a previous conversation with a different representative. Despite the unresolved issue, the member wishes to speak to a supervisor. How would you handle this situation, ensuring a resolution to the issue and appropriate escalation?

User Anne
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1 Answer

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Final answer:

To handle a member's complaint and request to speak to a supervisor, stay calm, listen attentively, avoid confrontational language, ask open-ended questions, and restate their concerns for clarity while focusing on resolving the issue. If a resolution isn't reached, escalate to a supervisor or HR.

Step-by-step explanation:

When a member of Aetna calls with a complaint about a previous conversation and wishes to escalate the issue, it's critical to choose your words carefully to not exacerbate the situation. Stay as calm as possible and listen attentively to the member's concerns, demonstrating your willingness to understand and address the problem.

It's important to avoid suggesting that you're right and the member is wrong, as keeping an open and respectful stance is essential for a constructive dialogue.Employ the strategy of asking open-ended questions to gather more information about the member's issue.

This technique encourages the member to share more details, potentially revealing the root cause of their dissatisfaction. Upon learning their story, restate what they've said to confirm your understanding, which affirms to the member that they are being heard and helps prevent misunderstandings.


Always keep the focus on solving the problem, rather than assigning blame. If the issue remains unresolved after your attempts, the next appropriate step is to escalate it to your supervisor or HR department, as they may have additional resources or authority to address the member's concerns satisfactorily.

User Velixo
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