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NEW QUESTION # 12
Case Study 1 - Humongous Insurance
Background
Humongous Insurance is contracted to process all insurance claims for a health facility that accepts the following types of health insurance:
* Health maintenance organization (HMO)
* Preferred-provider organization (PPO)
* Gold
Cases are classified as new claims, claim disputes, and follow-ups. Each insured person is entitled to open 25 new cases each calendar year.
Support representatives specialize by and process claims by insurance type.
Humongous Insurance currently accepts claims only by telephone. The call center is open from
06:00 GMT to 24:00 GMT daily. Call center staff work one of the following shifts: 06:00 GMT to
12:00 GMT, 12:00 GMT to 18:00 GMT, and 18:00 GMT to 24:00 GMT.
When a case is received by email, a staff member categorizes the case as email and closes the case immediately.
Current environment
* Humongous Insurance has three departments to handle claim types: HMO, PPO, and Gold.
* The company uses handwritten forms to send claims information to the correct department.
* Each department maintains a workbook to record calls received.
Requirements. Support desk
* Configure the system to track the number of insurance claims filed each year.
* Categorize claims by type as they are opened.
* Configure the system to track staff responsiveness to service-level agreements (SLAs).
* Ensure that business hours reflect the hours that support staff are scheduled.
Requirements. Case handling
* All new cases must be automatically placed into a queue based on insurance type after the type is selected.
* All insurance types need to be automatically moved to the proper queue when the subject is picked.
* All cases must be created and closed immediately when received.
* The status reason must be set to Email Sent or Phone Call.
* Information must be restricted by insurance and phone call type.
* Managers must be alerted when customers reach their limit of 25 cases for the year.
* Changes to cases must not be counted against entitlements until the case is closed.
Requirements. Disputes
* Claim disputes must be categorized as low priority.
* The status for all disputed cases must be set to Review by a Manager before a disputed case may be closed.
Requirements. Knowledge base
* A knowledge base must be used as a repository for all answers.
* Representatives must be able to search the knowledge base when opening a new case for similar claims.
* Representatives must be able to search across all entities at all times.
* Searches must check any field in the entity for matches in a single search.
* Searches must return results in a single list and sort the list so that the most relevant results appear at the top of the list.
* Representatives must be able to link the knowledge base to cases when applicable.
* Representatives must create a new knowledge base article if an answer is not found in the existing knowledge base.
* Representatives must be able to use SQL-like syntax to search the knowledge base.
Requirements. Service-level agreements
When a customer calls to open a claim, the company must respond to the caller within the following time frames:
Requirements. Alerts
* Cases must be flagged when they are past the SLA threshold.
* An email alert must be sent to the manager to indicate an SLA noncompliance.
* An email alert must be sent to representatives for SLA violations as follows: HMO 2 hours prior and PPO 1 hour prior.
* Send an email alert to support managers when disputes are ready to be closed.
* Send an email alert to customers when cases are closed.
Requirements. Issues
* The current process is all manual and not efficient.
* There is no easy way to determine whether the company is meeting its SLAs.
* Representatives are often inconsistent regarding how they handle customers and answer customer questions.
* There is no accountability for any of the representatives who take calls.
You need to search for answers to customer claims.
Which type of search should you perform?
Answer: D
Explanation:
https://docs.microsoft.com/en-us/dynamics365/customer-service/search-knowledge-articles- csh#knowledge-base-search-control
NEW QUESTION # 13
You configure Dynamics 365 Customer Service. Managers require a custom dashboard with the following:
* A list of customers who have the most cases open.
* A list of customers who have the most missed service-level agreements (SLAs) sorted by contact.
* A list of top call takers for the week.
* A list of the cases that took the most amount of time to resolve.
The custom dashboard must be available for all users to use.
You need to configure the system.
What should you configure? To answer, select the appropriate options in the answer area.
NOTE: Each correct selection is worth one point.
Answer:
Explanation:
Explanation
NEW QUESTION # 14
A company that manufactures industrial heating, ventilation, and air conditioning units (HVAC) is implementing Dynamics 365 Customer Service.
The company requires a presales solution that handles presales inquiries and existing customer support calls.
The solution must meet the following requirements:
Presales inquiry handling must be maintained separately from support call handling.
Presales inquiries captured from the company website must be handled by dedicated teams for each country on a first-come, first-served basis.
Support calls for specific HVAC systems must be directed only to their respective certified technicians.
You need to configure the solution.
Which components should you configure? To answer, select the appropriate options in the answer area.
NOTE: Each correct selection is worth one point.
Answer:
Explanation:
Explanation
Box 1: Queue
Presales inquiries captured from the company website must be handled by dedicated teams for each country on a first-come, first-served basis.
The idea of FIFO queuing, also called first-come, first-served (FCFS) queuing, is simple: The first item that arrives at a router is the first item to be handled.
Box 2: Workstream
Presales inquiry handling must be maintained separately from support call handling.
A workstream is a container to enrich, route, and assign work items. The workstream is associated with a channel, such as live chat, voice, or case.
The workstream can belong to multiple channels of the same type, like multiple chat channels. In this case, all the conversations from these channels inherit the routing and work assignment settings of the workstream they belong to.
Box 3: Assignment ruleset
Support calls for specific HVAC systems must be directed only to their respective certified technicians.
Assignment methods determine how a work item is assigned. You can use the out-of-the-box assignment methods or build custom assignment rules by configuring the prioritization rules and assignment rulesets The following assignment methods are available out of the box:
* Highest capacity: Assigns work item to the agent with the highest capacity, among those who have the skills identified during the classification stage, and who have the presence as specified in the allowed presence option of the workstream. In this assignment method, the work items are prioritized in the first in first out manner, that is, the work item that was created first is assigned first. If more than one agent is available with the same capacity, the work item is assigned randomly.
* Round robin
Reference:
https://www.sciencedirect.com/topics/computer-science/first-come-first-served
https://docs.microsoft.com/en-us/dynamics365/customer-service/create-workstreams
https://docs.microsoft.com/en-us/dynamics365/customer-service/assignment-methods
NEW QUESTION # 15
Hotspot Question
You are a Dynamics 365 for Customer Service administrator. The organization has multiple business process flows for warranty management.
You need to manage business process flows.
What should you configure? To answer, select the appropriate configuration in the answer area.
NOTE: Each correct selection is worth one point.
Answer:
Explanation:
NEW QUESTION # 16
Drag and Drop Question
Your company uses Dynamics 365 Customer Service.
The company wants to send a customer survey to each customer when a case is closed. The survey must include the following:
- An area with a list of questions that rate the answers as poor,
average, or great.
- A question that rates whether the customer would recommend your
company to others.
The company wants to exclude symbols from any of the question types.
You need to configure the question types.
Which question type should you use? To answer, drag the appropriate question type to the correct requirement. Each question type may be used once, more than once, or not at all. You may need to drag the split bar between panes or scroll to view content.
NOTE: Each correct selection is worth one point.
Answer:
Explanation:
NEW QUESTION # 17
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