Table of Contents

CheckUp Handbook

Getting Started

Welcome to Cortex, we're excited to have you join the CheckUp team!  You will be making follow-up calls to mostly elderly patients who are currently receiving home health services, recently discharged from home health services, a resident of long term care, or recently discharged from a skilled nursing facility.  The purpose of our call is to gather valuable information about the patients health status & gather feedback about their experience so we can alert their care team of anything that needs attention.  Teamed up with Cortex, you are making a difference in patient outcomes.  Keep in mind you are not giving medical advice, you are just checking in and gathering information. 

The purpose of the CheckUp call is to provide agencies and facilities with the information they need to better serve the patient.  You'll be gathering important details that will be relayed to the patient's care team.  

Cortex requires nurses to be compassionate, kind,  conversational & friendly.  

Requirements

Training

• • Read through this handbook and understand how to navigate calls. 

  • Complete a training comprehension quiz with 100% (within 3 attempts) 

Credentials

• • Valid US driver's license or identification (passport, government issued ID)

  • Professional Liability Insurance

  • Reside within the United States -  RNs must reside within the US.  Logging into the Cortex portal outside of the US is not permitted.

Quiet & Secure Location

• • Calls must be made in a quiet and secure location.  

  • No background noise should be heard on calls.  

  • Keep your area quiet so TVs, dogs barking aren’t heard on the call when speaking with patients.  If background noise is heard on a call your account could be suspended.

Professional Liability Insurance

• • As an independent contractor making follow-up calls as a Registered Nurse, Cortex requires you to have professional liability insurance in place.

  • Policy Requirements:  Occurrence, Self-Employed Professional Liability policy with limits of not less than $1 million per claim and $3 million per annual aggregate. This is to protect you and your family in the unlikely event that any claims that may arise while making follow-up calls to patients.

You may choose any professional liability insurance that meets the minimum requirements from any reasonable and legitimate insurance carrier in the U.S.

Cortex does have a recommended provider that is both quick and easy. 

NSO provides quick quotes & fast turnaround. You don’t need to purchase the policy until the final step in your application & you are actively in the onboarding process.   NSO Professional Liability Ins

If you plan to obtain NSO you can follow this guide -  Insurance Guide

Required Devices & Equipment

• High-speed internet

• Computer or  laptop (tablet with a keyboard can work, but is not recommended) 

  • Your computer or laptop should be in proper working conditions, current & up to date  to ensure proper function.

  • Calls will be made to patients directly from the Cortex platform on your computer via the internet, you will not be using your personal phone. 

• Google Chrome is necessary to make calls on the Cortex platform.

• Headset with a microphone  (Example Headset on Amazon)

• Antivirus software installed on your device

• Slack - team communication.  Slack is a messaging app which can be used on a browser or app downloaded on your computer/laptop or even your phone.  Please have slack active while you are working in order to communicate with the Cortex team and your fellow teammates.  You’ll be required to check in on slack for important updates.  This is a great place to ask questions and get to know your teammates. 

  • You can adjust the settings and notifications to allow for your preferences. 

50 Successful Calls each month

• We require our CheckUp callers to complete at least 50 successful calls every month to remain active as a caller.  

• This is approximately 5 hrs a month

• Monthly Exemption - we understand you may encounter a circumstance that prevents you from occasionally completing this monthly call quota.  If you have an issue please reach out to the Cortex team and we can typically provide an accommodation within reason.

• If a caller fails to complete 50 successful calls on a regular basis your account may be deactivated.

Compensation 💲

• Payment is $2.50 per successful call and 10 cents per no answer

• Hourly compensation will vary based on a few factors - how efficient you are on your calls, time of day, how many people are answering their phones. 

• On average, our nurses make an average of $25/hr.

• Average successful calls are 8 -12 per hour 

  • Don’t get discouraged as you first start out, your hourly success rate will increase once you get the hang of things!    

• This rate is lower than working at a hospital because it’s much easier and way more flexible than an in person nursing job.  This position is designed to be a source of supplemental income for working nurses, nurses looking for flexible work or retired nurses.  We have many nurses who have been with Cortex for a long time!  We hope you love it too!  Cortex sometimes has other projects if you are interested - keep an eye out for these on Slack in the #job-opportunities channel. 

When do I get paid? 

Every time you complete a call on the platform your balance  will reflect the current amount & when you reach $25 a payment will be sent.  You can see your balance on the calling screen.

We have partnered with Stripe and use Stripe Connect.  To receive payment, you'll need to enter your debit card into our secure Stripe portal. You should be prompted to do this when you first log into Cortex after being onboarded.   If you ever have issues with Stripe, please contact Stripe’s customer support.  

*Please make sure to update any changes to address or bank account information in Stripe immediately.

• Bonuses & Incentives  - You may qualify for these bonuses by making great quality calls or making a certain amount of calls each week/month.  You'll see incentive opportunities posted in slack. 

Independent Contractor (1099)

An independent contractor is a person or business that provides goods or services to another entity under terms specified in a contract and are usually paid on a freelance basis. The only requirement we have is that you make at least 50 successful calls per month.  Independent contractors are not employees. They do not qualify for benefits and do not have income taxes withheld like regular employees (W-2).

Can Cortex verify my employment?
Nurse callers are contractors for Cortex, not employees, therefore we cannot verify employment.  However, we can verify that you are a contractor with Cortex.                   Send these requests to success@cortexhc.com

Taxes

The amount you get paid is the pre-tax amount. You will be classified as an independent contractor (1099) and responsible for your own taxes based on local, state and IRS rules.  If you earn greater than $600 per calendar year through Cortex, you will need to file a 1099-MISC in your taxes. Therefore, you need to be prepared to keep a portion of your earnings for taxes.  How much you will  pay in taxes depends on how much income you make, your tax bracket, the state in which you file and many other factors.  We typically recommend that you set aside about 20-30% of your CheckUp call income for taxes. When in doubt, you should speak with a tax/accounting professional. 

Hours of Operation

Monday - Saturday 7am - 9pm MST 

Sunday 7 am - 6 pm MST

Time Zones

Calls will populate in the queue based on the patient's time zone.  If there are calls in the queue - you can make them!  We’ll make sure you don’t call a patient in another time zone too early or too late.  

Closed

Thanksgiving Day 

Christmas Day 

Calls are available to be made on other holidays - Memorial Day, Fourth of July, Christmas Eve, etc. if you wish, but it is never required. 

Call Best Practices & Expectations

• Make calls in a quiet & secure location

• Be conversational, friendly and professional (don’t sound like a robot, patients don’t respond well to dry conversations - a little personality goes a long way!)

• Keep your calls within 2 - 5 minutes  (on most calls)

• Use proper & clear English (or language of queue) We currently support English, Spanish & Russian -- if you speak another language please reach out to our team. 

• Always follow the instructions for each call

• Remain neutral if a family member or patient is upset or angry about their care.  Avoid picking sides - remain neutral & say “I’m sorry you had that experience".  

• Pronounce the facility/agency name correctly.  

  • There is a blue speaker button beside each facility name you will be calling that will tell you how to say the name correctly.  This is extremely important!  Our customers want their names pronounced correctly.  If in doubt, please reach out!

• Always mention that you are calling on a recorded line

• Always have Slack open during your working hours.  Check slack every time you login to Cortex for important updates and quick access to ask questions and connect with your fellow team members.

• Follow HIPAA standards (never disclose patient information -   You are only gathering information - you should never provide medications, diagnoses, or any information you have on your screen.  Don’t disclose any patient information to anyone.

• Follow Cortex protocol for reporting Emergencies any suspected allegations of neglect or abuse 

How to be a Successful Cortex Caller

Our goal is to provide agencies/ facilities with the best information to better care for their patients and for Cortex users to financially benefit from making calls. This is a quick guide to help you make the most of Cortex.

• Quick internet speed 

• Google Chrome browser (Newest update always recommended)

• Modern, well-equipped PC/Laptop with sufficient RAM (8GB or more)

• High quality headset (if you are having audio issues, it’s often your headset)

• Moderate Chrome tab usage - if you have a lot of tabs open it uses a lot of RAM.  

• No other processor-intensive applications running at the same time you are making calls.

• Wired Internet connection isn’t required, but is great if you are experiencing issues.

• We recommend setting a schedule to follow to ensure you are consistent and able to hit your calling goals. 

• Complete your monthly 50 successful calls in the first 3 weeks of the month -- we have the most calls in the queue during the first 3 weeks each month and experience fewer calls during the last week of the month.  To ensure you are able to complete 50 successful calls, we advise you don’t wait until the last week of the month. 

Your account will be immediately suspended if you 🚫

• Ever give advice to a patient.

  • If a patient has a question, let them know that you’ll write it down. You can instruct the patient to follow their physician’s orders or to reach out to a health care provider with their specific questions.

  • If the patient asks a question that is not advice-based, such as a general knowledge question, you may answer. 

    • For example if a patient asks what CPAP machine is used for you may tell them if you feel comfortable. You cannot tell that patient how they should use the device though. 

• • Break any HIPAA regulations.

  • Share your login information with anyone

  • Save patient information

  • Share patient information

  • Modify or attempt to modify any code or database information

  • Make calls in an unsecure location

  • Are rude or otherwise inappropriate.

Your account may be suspended if you have difficulty asking the questions or reporting the answers, a customer complains, background noise, failure to call in a quiet & secure location, failing to mention you are on a recorded line, marking incorrect call outcomes, not having a friendly demeanor or for any other reason we deem appropriate. 

Experiencing Technical Issues

If you ever experience a technical issue or glitch such as a page not loading, a page is spinning, a link not working, your login not working, etc. we suggest trying the following:

• Make sure you are using Google Chrome and it is up to date.

• Try using this url: http://portal.cortexhc.com/login

• Make sure Google Chrome is up to date (check for any updates)

• Do a hard refresh (CTRL + Shift + R)

• Restart your computer

• Log out and back in

• Restart your modem 

• Clear your cache & cookies 

*If none of these help to resolve your issue, please reach out to support on slack in the #checkup-team channel 

Why does Cortex have RNs make follow-up calls to our customer’s patients?

• When contracting to provide follow-up calls to our clients’ patients, we make clear that our contractors will not be providing medical or nursing advice/care, and will not make any medical or health assessments.  Rather, our calls are intended to improve the satisfaction of our client’s patients, and to help facilitate the flow of information between our clients and their patients. 

• In conducting the calls, Cortex contractors are utilizing a script created by our clients, and are supposed to closely follow the pre-designated script, including asking designated questions. The calls are recorded.  The job of a Cortex contractor is to carefully and accurately document the patient's status and information relayed.  Once our contractor submits the call information in our software, all the data is sent to the provider. At such a point, the handoff of information has occurred, and it’s now our client’s responsibility to take appropriate action.  Clients can then review the call, disposition and audio recording, and determine the appropriate action.  

• Of course, as part of these follow-up calls, patients will sometimes relay important health-related information to Cortex contractors (e.g. “my medical equipment hasn’t arrived”) which is then carefully documented and relayed to our customers. However, it is solely the responsibility of our customers to respond to such information.  

• Given the nature of Cortex’s contracted role, and our strict guidelines, it is critical that when conducting follow-up calls, our contractors do not provide any advice that could be construed as the provision of medical or health advice.  Again, our role is to follow the message created by our customer, ensure high customer service, and to relay any important information learned from the call, to our customers.  Our customers then provide appropriate follow-up care, as may be needed.

• Given the nature of Cortex’s role, Cortex is not required to have licensed nurses make follow-up patient calls. However, we have chosen to do so for several practical reasons.  For example, we found nurses typically:

  • Have great “phone-side” manners, are compassionate and understanding.

  • Have relevant insight and knowledge, including:

    • Understanding medical terminology and information that may be relayed during a call.

    • Asking good clarification questions and being able to identify areas of concern that should be documented and relayed to our customers.

    • Documenting information in a manner similar to medical charting, better ensuring our customers’ staff can quickly identify and follow-up on potential issues.

As relayed above, our customers have the legal responsibility to care for their patients.  Cortex’s follow-up calls are just a tool to better allow our customers to detect when a patient is not satisfied, is not receiving proper care, or is having issues that need to be addressed.

As relayed in your training and outlined above, never give medical, nursing or health advice on these calls.  If a patient has non-urgent questions or concerns, you should state you’ll provide all information to their provider, who will then directly follow-up (and if they haven’t heard from the provider within an appropriate time-frame, they should directly contact their provider or seek other medical attention).  Of course, if the information relayed is concerning enough, advise them to seek appropriate medical advice/care, without waiting to hear from their provider.  Moreover, if you feel the patient could be having a medical emergency, strongly encourage them to call 911 or go to the nearest emergency room. 

Call Outcomes

This next section covers call outcomes.  We know there are a ton of outcomes to choose from!  

For the most part - you’ll generally be marking only a few of these call outcomes. 

It’s very important to mark the correct call outcome - if a wrong outcome is selected it could potentially remove patients from future calls, so please refer back to the handbook once you start to review the outcome selections.  

You can also ask in slack!  The Cortex support team & other nurses are super helpful to answer questions when you are first starting out.

Ready for questions

The first option ‘Ready for Questions’ must be selected in order to be able to answer the questions and hit submit.

Call Back Later

If a patient/family member is not able to talk now but would like a call back later, mark this outcome.  You can also schedule a call back by time/date. 

No Answer

Select this outcome when no one answers the phone or if you get a voicemail.  

Select this outcome even if the voicemail doesn't say the patient's name- it might be a family member or caregiver's phone number.  

Select this outcome if you hear only silence after calling, this indicates a temporary connection issue and is not a wrong number. Please be sure you are letting the phone ring until VM picks up or at least rings a minimum of 30 - 45 seconds.

Wrong number : A human told me

Select this when a person tells you “wrong number”, if a person/family member/caregiver tells you this is not a good number to reach the patient or to get information about the patient. (If you can obtain a different number to contact the patient please add that number.)  If the family member is unable to answer questions, but says they don’t want 

their number to be removed,  mark “wrong number.”  Let them know the HH/SNF will still have their number.  We won’t be making follow up calls to that number anymore since they are unable to answer our questions. 

Wrong number : fax /number disconnected

Select this outcome if it is a fax machine or the number is disconnected.  Keep in 

mind this is not to be selected when the phone line is busy.  

Wrong number : Automated message

Select this outcome if the automated message says it is a wrong number, if it has 

been disconnected, if it is not a working number, if the call cannot be completed.  

Do not mark this response when you get voicemail, even if the voicemail doesn't say the patient's name.  Oftentimes we have the number for a family member or caregiver. Mark no answer when you get a voicemail.  

Facility unable to transfer

Mark this if a facility where a patient resides says they can't transfer the call to the patient’s room. Do not mark this call as a wrong number. It is best to mark the most specific outcome as possible to provide the most accurate reporting information about the patients to their care team members.

Patient cannot hear me well

Mark this when there is a connection issue due to the phone or internet & the call quality is bad.  Do not mark this if the patient is hard of hearing.  If a patient is incapable of speaking on the phone or they are very hard of hearing, mark “wrong number” so we will be able to call family members that can speak on the phone.

Patient requests do not call again

Mark this outcome if a patient asks you not to call back.  You must have permission from the patient before marking this outcome. You can only mark this outcome if the patient or their spouse requests no more calls. If you call and are immediately hung up, mark that as "No Answer."  You must always have permission to remove them from future calls. If a patient is clearly annoyed with the call you can offer to remove them from future calls, and after you get permission you can mark this response. Before you select this option there are a couple of factors to consider. Once this option has been selected it means that this Patient will NEVER receive calls from us again. That means they are not getting checked up on and will be less protected. Always make sure this option is verbalized and the patient or caregiver understands that they will never get check-up calls again from the facility.

Patient has not received services from provider

Mark this outcome ONLY if the patient has never had services from the HH/SNF.

If no one from HH has been out to the patient’s home or if they were never at the SNF. 

ASK questions to clarify if they’ve seen a nurse or therapist at their home, if they had surgery or were in the hospital, sometimes this will help remind them that they did have services.  

Patient passed away / Patient passed away in a SNF

Mark this outcome if you find the patient has passed away.  If they passed away in the SNF you are calling on behalf of, mark “patient passed away in a SNF.”  

Follow the prompted script:  “I am so sorry to hear that. Thank you so much for allowing us to be a part of their care. I will be sure to let the team that cared for them know. Sending our best (not have a nice day)."

Patient does not speak my language

Mark this outcome if you speak with a person and they don’t speak your language.  Don’t mark this outcome if you get a voicemail in a language you don’t speak.  If you get a voicemail in another language, mark that “no answer” as you would with any voicemail.    

Patient Currently on Hospice

Mark this outcome if you find out the patient is currently in hospice care.  

There is a brief script you can follow when you find out a patient is in hospice.

 “Thank you very much for letting us know. We have appreciated being a part of their care. Goodbye.” Please do not go forward with questions on the call. Just mark the outcome and submit.

Patient currently at/on way to hospital

Mark this outcome if a patient is currently at the hospital or on the way to the hospital.  Ask the questions that you'll be prompted when selecting this outcome.  For example - why are they at the hospital, when is their discharge, which hospital they are at.  Please do not go forward with the questions on the call script. Simply mark this outcome, ask the prompted hospital questions and submit the call.

Discharged from SNF to Hospital

Mark this outcome if the patient was discharged/taken from the SNF to the hospital.

Patient at a new home health (unsubscribed)

Mark this outcome if you are calling for a HH company and you find out the patient is now using a different HH company and no longer would like calls from the previous home health company. 

Patient at a new SNF (unsubscribed)

Only mark this outcome if the script indicates to do so upon finding out the patient is currently at a new SNF. If the script does not indicate to mark this outcome, please go forward with the call. Please be sure it is a SNF and not an assisted living facility.  Ask a follow up question if you need to clarify this response.  If they are living at an assisted living facility, you would complete the call as usual and ask all or most questions. 

Relation to Patient

If someone besides the patient answers the call, you must document their relationship to the patient and name in this section of the call.

Nurse Caller Questions

At the bottom of each page on the calling screen, you'll see a gray section of questions.  

These questions are ONLY for you - the nurse caller to anser based on the information given to you.  If you don't answer the question while asking that page's questions, you will need to answer it on the last page prior to submission of the call.  You do NOT ask these questions to the patient. 

Special Instructions

• Some customers have specific instructions you’ll need to follow on calls.  Most of the time you’ll be able to read the Instructions on the screen and know what you need to do.  We have one customer who has a few instructions that need to be followed and we have a separate guide which you can find here:  Healthflex Guide

• After you have been onboarded for this position, you’ll want to take a few minutes and familiarize yourself with this guide to ensure you are aware of these specific instructions.

FAQ ❓❓

I Can't log in, I'm just getting the spinning wheel

• Trying using this url: http://portal.cortexhc.com/login

• Also do a hard refresh CONTROL + SHIFT + R

• Clear your cache

Do I need to ask the questions in the script word-for-word?

•  Most calls, you can be conversational and you do not need to read the questions on the script word-for-word to the patient. It should sound like you are calling to check in with the patient in a friendly way and not like you are reading monotonously through a script.  However, if the instruction section on the call state you need ask questions word-for-word, please follow the instructions. 

What should I do if a patient doesn't answer a question?

• Never mark false responses, accurately select the answer that the patient disclosed.  Please make sure your answer selections are very accurate and reflect an honest account from the patient.  If they didn’t answer a question, or won’t answer a question - please leave it blank.  Of course we want you to ask all or most questions on every call, but occasionally if a question isn’t answered because a patient didn’t want to complete it - we understand.  

Can I answer a patient's question?

• You CAN answer general informational questions if you are confident about the answer (e.i. What is a good blood sugar level? What does a CPAP machine do? What does Coumadmin do?) You CANNOT answer questions about medical advice (i.e. “Should I walk on my knee even though it keeps popping?” Or “What medication would you recommend?”) 

• When it comes to these medical advice questions, you should discuss the concerns/questions on the call and let them know these questions will be passed along to the cusomer/location. If the patient needs immediate healthcare attention you should follow the emergency protocol.

•  What do I do if a patient is verbally abusive or using profanity at me on a call?

  • If a patient is being verbally abusive, using profanity at you or being inappropriate you can hang up the phone.  If you were able to get some valuable information on the call, you can submit the call successfully.  If no valuable information was obtained,  you can mark “no answer.”  Please message us in Slack and give us the patient’s name so we can remove them from future calls.  If you have any questions on how to mark this call, please message in Slack. 

•  Do I have to ask all the questions on every call?

  •  You are not required to ask every question on every call, but you should try to ask most or all questions on most calls.  You should be asking as many questions as possible.  If a patient needs to go half way through the call and you gathered valuable information you can submit te call.  If a patient is clearly annoyed and doesn’t want to finish all the questions you can submit the call with the valuable information obtained.

• Hung up after hearing me or my intro?

  • The best option would be to mark the call as "No Answer", since you never spoke to the patient. "Call back later" and "do not call again" must be verbalized! 

• The same patient keeps popping up again & again after I already submitted ‘no answer’.

  • Many patients have several phone numbers listed in the Cortex system, likely what you are seeing is a call for a different phone number associated with the patient. You will have to call through all numbers before you can be assigned a new patient.

•  Patient hung up or is being ‘weird’ -I  think they want to be left alone?

  • Mark as ‘No Answer’ or ‘Call Back Later’. Don’t select “patient requests do not contact”. We need more information and direct permission from the patient before we can do that. 

•  Patient does not want to complete a survey, how do I deal with it?

  • Explain to the patient that this is not a survey, but rather a follow up from their facility. It is included in their care. If they still don’t want to talk, mark the call as “Call back later”. Try not to select “patient requests do not contact” unless the patient specifically mentions it. This will remove them from all future calls, no matter the facility. 

• It says there are 38 - 56 calls in the queue, but when I call it says there are no calls available.

  • That is the estimated number of calls available and it isn’t perfect. Usually if the number says 40 or less there are no available calls. This is because our nurses are working nationwide and those call opportunities displayed are probably currently in progress. However, calls are added throughout the day so check back later! 

• The person who answered the phone cannot give me information about the patient, but they gave me a better number to call. 

  • First add the phone number by clicking “Add + Number” on the left hand side of the screen. Then you may mark this call as “Wrong number: a human told me”. 

• When a patient or patient's caregiver asks if a home health nurse can come to visit a patient today how should I answer that? 

  • Let them know this information will be passed along to their care team via the call.   You may tell the patient/caregiver to call the HH as you aren’t certain when they’ll see your message. 

•  How many successful calls should I aim to make per hour?

  • 8-12 is a good goal

•  What if a patient or family member asks who you  work for?

  • Let them know you don’t work at the facility, but work with another company that helps them make these follow-up calls.

  • If anyone asks to speak with a manager at the facility - you can say you don’t work at the facility, but this information that we are discussing will be passed along to them.  You can encourage them to call the facility too if they'd like to reach out you can provide the phone number which is the last question on the call. 

•  What do I do if a patient/family member is upset with the facility I’m calling for? 

  • Remain neutral on the subject &  refrain from ‘taking a side’ or agreeing/disagreeing with the complaints of the patient.  

• What should my introduction sound like? 

  • When you call it would be great to say something like "I am calling regarding George" instead of saying “Is George available”?  Oftentimes George has dementia and/or hearing loss and the patient/family member would expect us to know this.  If you say you are calling “Regarding George" it is a safer introduction that encompasses more scenarios. Also don’t forget to state you’re calling on a recorded line. 

• What should I do if a patient has a medical question? 

  • Please be sure to follow the guidelines for a patient who is on- service versus off-service or discharged from a SNF.  If a patient is currently on service with a home health agency, you can recommend the patient follow up with their home health nurse or therapist with any questions they have.  If the patient has been discharged from a SNF or HH company, typically there is not much the company can do since the patient is discharged.  If a discharged patient has any questions or concerns about their health, have the patient reach out to their doctor.  

• How should I address the patient or family member?

  • To remain professional, you should always address a patient or family member by their name, Mr./Mrs/Ms./Miss or by their preferred name. 

• Are the calls scripted?

  • All calls include instructions, an introduction, and the questions the agency/facility would like us to ask. You also are required to let everyone you speak with know that you are calling on a recorded line. Cortex encourages our nurses to sound conversational and  unscripted when speaking with patients or family members. Please make sure to ask as many questions on the script as possible. Most calls you should be asking all of the questions. However, you may use your judgment and skip questions if you feel appropriate.

• Can I speak with someone other than the patient? 

  • Yes, oftentimes you’ll speak with a family member or caregiver.  If the person you reach isn’t able to answer your questions, you’ll mark the call “wrong number.”

• What if a patient or family member wants to tell me their life-story and the call is taking a while?

  • Politely steer the conversation back to the questions

  • Say something like - “Thanks for telling me this, is it alright if we go back to these questions I have for you today?”

• What if you call and the patient answers your first question that they are feeling better, but is about to leave?

  • Say something like “I’m glad you are feeling better.  Do you have a moment to answer a few questions about your health before you go?”  If they say no, please thank them and end the call.  Fill only the questions you were able to answer & submit the call even if it's only a couple of questions.  

  • If no questions were answered - please select the outcome “call back later”

• Do you have to ask every question on the call?

  • You are NOT required to ask every question on the call, but you should ask all or most questions on most calls.  

• How do I contact Cortex support about questions on calls or to report emergencies?

  • Message us in Slack in the #emergency-calls-checkup channel.

 Call Quality ⭐️⭐️⭐️⭐️⭐️

Call Quality is very important!  Our customers rely on us to provide  amazing interactions & calls to their patients.  The Cortex Quality team reviews all nurse calls regularly.  

When your call is reviewed you’ll receive an email with a star rating and some feedback about the call.  You will also be able to listen to the call.  Calls are rated on a star scale of 1-5.  Five being the best and one being the lowest score.   Both the Cortex team and our Customers (the location the call was made on behalf of) can review your calls.  

Customer Call Reviews:  If you have a call review from a customer and have any questions, please reach out to us.  If you receive a negative rating from a customer our team is also alerted & we’ll be reaching out to you as well. 

Call reviews are for coaching & feedback - we are here to help you succeed & this is how we provide our coaching.  If you have any questions about what you could do better, please reach out to us. 

Please take call  reviews seriously, if you receive low star ratings on a regular basis your account may be suspended.  Strive to receive 4 and 5 star ratings, 3 and below is considered to be average to poor and would need changes implemented to increase your rating. 

Below ⬇️ is the Cortex team call rubric - all calls are rated based on this rubric. 

5 Star Call  ⭐⭐⭐⭐⭐

• Identifies self & facility you are calling for 

• States you are calling on a recorded line

• Polite/friendly/conversational/empathetic 

• Call length is between 2-5 minutes

• Asks good follow up questions to gather valuable information

• Select correct answers

• No background noise from nurse’s side of call

• Uses proper and clear English (or language of choice)

• Marks all answers correctly 

• Remains neutral

• Ask who you are speaking with if it’s not the patient & noting the name / relationship of the person you are speaking with. 

 2 - 4 Star Call ⭐⭐⭐

• Star ratings in this range will vary based on quality of the call

• Star rating will be below 5 if you missed items from the above “5”star call requirements. 

1 Star Call ⭐

• Does none or very little of things outlined in “5 ⭐” section

• Fails to mention “calling on a recorded line”

• Gives medical advice

• Not staying neutral when a patient or family complains

• Selects “Do Not Call Back” call outcome incorrectly

• Breaks HIPPA regulations

• Gives out phone numbers or names to anyone other than the patient

• Is rude, unprofessional or otherwise inappropriate

• Marks incorrect call outcome

• Marks an answer that wasn’t asked 

• Background noise 

• Wrong pronunciation of Facility

• Attempting to speak to someone while they drive

• Not allowing the phone to ring for at least 30 seconds or until VM 

• Completing a call when an employee of the HH is present in the  home

• Completing a call when a patient says they don’t have time for the call

• Not following emergency protocol or elder abuse reporting protocol

• Not asking who you are speaking with if it’s not the patient & not noting this on the call page.

Emergency Protocol 🚨

As you are calling patients that have recently received medical care, it is possible that they may be at risk or potentially experiencing a medical emergency. A medical emergency is defined as an acute injury or illness that poses an immediate risk to a person's life or long-term health.  If you have a call that requires you follow emergency protocol, you’ll also be reaching out to the customer to alert them about the situation.  Because of the extra time these calls can take, successful emergency calls are paid at extra $1.50 each.

If during a call you discover that a patient needs immediate healthcare attention, or their healthcare provider should immediately know about a concern, please initiate our emergency protocol.

Emergency Protocol

• Immediately life threatening

FIRST - Have the patient call 911. (As long as you instruct the patient to do so, that is all you can do. The patient may refuse, but that is their decision.)

SECOND - Call the HHA or SNF of which you are calling on behalf of using on the bottom left of your screen.

THIRD - Message Cortex in Slack on the #emergency-calls-checkup channel immediately. Explain the situation briefly and let us know what actions you took to address the concern.

If the HHA or SNF does not answer AND Cortex support does not respond to your message in Slack, call Cortex support at (801) 770-4002. The only reason you would need to call Cortex support is if you cannot get a hold of the agency/facility AND no one has responded to your slack message in a timely manner.

• NOT immediately life threatening

FIRST - Call the HHA or SNF of which you are calling on behalf of using the emergency button on the Cortex platform. Leave a message if they do not answer.

SECOND - Message Cortex in Slack on the #emergency-calls-checkup channel immediately. Explain the situation briefly and let us know what actions you took to address the concern. Explain the situation briefly and let us know what actions you took to address the concern.

THIRD - If the HHA or SNF does not answer AND Cortex customer support does not respond to your message, call Cortex support at (801) 770 - 4002. The only reason you would need to call Cortex support is if you cannot get a hold of the agency/facility AND no one has responded to your Slack message in a timely manner.

Last resort is to suggest the patient calls 911.

Reporting Elder or Vulnerable adult Abuse allegations 

(see the definition of elder abuse below) 

When should a Cortex RN alert support regarding abuse?

• The patient’s life is in immediate danger

• The patient or family member needs immediate help

• The patient or family member states the word “abuse” or “neglect”

Things Cortex RNs don’t need to alert support about.

• Potential neglect

• Someone threatening legal action

• Dissatisfied patient/family member

FIRST - Immediately Slack into the #emergency-calls-checkup channel. 

1. Provide the link to the call

2. Provide a brief summary abuse/neglect allegations

3. Cortex Support Team will alert AJ Smith immediately (if she is unreachable they will escalate to a member of the Compliance Executive Team).

4. If the Support team is unavailable (after hours, weekend) and the patient is NOT in immediate danger, please leave a message in the #emergency-calls-checkup channel with the link and a brief summary of the abuse/neglect allegations.

SECOND - If the patient is in Immediate Danger and  if the support team is unavailable  

      (after hours or the weekend)  on Slack --- Monday - Friday 8am-3pm MST / 10am EST-5pm       

1. Call AJ Smith at (801) 770-4002

If AJ Smith is not reachable please escalate the issue to another Compliance Executive team member in the following order:

2. Alyssa Pitts (801) 638 -8586

3. Sarah Stevens (315) 664-2116

4. Riley Adamson (801) 923-2020

The Cortex Compliance Team will document & report the abuse allegations to the Customer and follow up per Cortex Abuse Allegation Policy. 

Compliance and Non-Retaliation

Compliance with this policy is mandatory for all RN Callers.

If an RN Caller feels obligated to report separately from this policy, Cortex will not try to infringe upon the RN Caller’s desire to do so.

Cortex strictly prohibits any form of retaliation against individuals who report abuse allegations in good faith.

Elder Abuse Definition

An Elder is someone 65 years of age and older.

Elder Abuse means physical abuse, neglect, financial abuse, abandonment, isolation, abduction or other treatment resulting in physical harm or pain or mental suffering to an elder. It also means the deprivation by a care custodian of goods or services that are necessary to avoid physical harm or mental suffering.

• Abandonment: The desertion of an elder by someone who is a caregiver.

• Abduction: The removal, without the consent of the conservator, of a conservatee to another state.

• Financial Abuse: The illegal or unethical exploitation and/or use of an elder’s funds, property or other assets.

• Isolation: The intentional prevention of an elder from receiving mail, telephone calls or visitors.

• Mental Suffering: The infliction of fear, agitation, confusion through threats, harassment or other forms of intimidating behavior. 

• Neglect: The failure to fulfill a caretaking obligation such as assisting in personal hygiene, providing food, clothing or shelter, protecting an elder from health and safety hazards, or preventing malnutrition.

• Physical Abuse: The infliction of physical pain or injury, sexual assault or molestation, or use of physical or chemical restraints for punishment. 

Suicidal Protocol (if a patient expresses suicidal thoughts or intentions)

First - Have the patient call 911 and give the patient the National Suicide Prevention Lifeline 1-800-273-8255 or tell them to call 988

Second - Call the HHA or SNF of which you are calling on behalf of using the Cortex platform. Leave a message if they do not answer.

Third - Message Cortex support immediately on Slack #emergency-calls-checkup channel. Explain the situation briefly and let us know what actions you took to address the concern.

Last - The only reason you would need to call Cortex Support is if you cannot get a hold of the agency/facility AND no one has responded to your Slack message in a timely manner. You can call Cortex support at (801) 770 - 4002.

Additional info 

You can find tips and reminders on the nurse calling platform.  

Look for these when you make calls and keep an eye on them for great reminders!  

• Recorded Line - It is extremely important that you say you are calling on a recorded line for all calls. Please also be sure to follow the intro script and say calling on behalf / from the companies when prompted on each call.  Certain states we call require that you state you are on a recorded line. 

• Introduction - When calling it's great to say something like "I am calling regarding George" instead of saying “Is George available”?  Oftentimes George has dementia and/or hearing loss and the patient/family member would expect us to know this.  If you say you are calling “Regarding George" it is a safer introduction that encompasses more scenarios.

• Caller ID - Patients will see a number with the same area code as the customer.  Sometimes it might actually be the customer's number, but not always.  If a patient is unable to write down a phone number, let them know the phone number will be in a folder/pamphlet given to them by the SNF/HH agency.  Please do your best to give them the phone number for the location on the last question of each call if they would like it.  

• On Service vs Off Service patients - Please be sure to follow the guidelines for a patient who is on- service versus off-service or discharged from a SNF.  If a patient is currently on service with a home health agency, you can recommend the patient follow up with their home health nurse or therapist with any questions they have.  If the patient has been discharged from a SNF or HH company, typically there is not much the company can do since the patient is discharged.  If a discharged patient has any questions or concerns about their health, have the patient reach out to their doctor.  

For example:

A nurse made a phone call to a patient who has been discharged from home health for a few months.  The patient reported a new symptom of itching which was concerning to him.  Since the patient is off service, the best thing to do is discuss their concerns & symptoms as they'll be recorded on the call and then tell the patient to reach out to their doctor.  Since the patient has been discharged from home health, there isn't anything the HH company can do to immediately help without a new order for home health (which can take days).  

• CoreQ - CoreQ is a short stay discharge call to residents who stayed less than 100 days at a SNF.  These are CMS (Medicare) calls and require that the CoreQ questions are asked verbatim.  If a call has CoreQ questions you’ll be notified of the instructions for that call.  Please pick the patient's accurate response and give them their options - Very Good, Good, Average or Poor.  Not all questions on the call are CoreQ questions.  The other non-CoreQ questions can be more conversational, but be sure to follow the questions and the script answers closely when asking CoreQ questions.  Currently The Villa (facilities) are the only customer asking these questions.