Processing Member Requests to Change Programs and Providers

 This article outlines the process for Agents to use the Health Guide Platform (HGP) to process member requests for changing their program or care team structure. Beginning at Part 1 this is a Tier 2 process.

Important Changes:

• This feature is found under the Requests feature in the HGP.

⚠️ CRITICAL WARNINGS BEFORE YOU START

1. Therapy Requests: Do NOT use this tool for Therapy program changes.

   • See Article: Processing Member Requests to change to/from Therapy

2. Switching Providers of the SAME Type: If a member wants to switch from one provider to another of the same discipline (e.g., Coach to  Coach, or RD to RD or VMP to VMP), do not use the "Request" feature.

   • Action: Use the "Switch Provider" feature in the Health Guide Platform. This ensures the algorithm finds the soonest available appointment. Please do not switch VMP if it has not been two weeks since the members last appointment. 

   • See Article:Processing Member Requests to Change VMP

   • If it is not one of these requests and requires the below process please escalate to Tier 2.

Part 1: Pre-Submission Checks (Mandatory)

To be performed by Tier 2 only. To prevent system errors ("extra team codes") and duplicate tickets, you must verify the following in Admin before submitting a request.

NOTE: If any of these 3 scenarios are taking place do NOT use the Referral Process. You must first check to validate that the member's situation is not any one of these three scenarios. 

[Image: Screenshot of Admin Search Bar showing where to search email]

1. Check for Duplicates

Under Referral management> referrals in Admin

Search the member's email in Admin. Ensure another agent or coach has not already submitted a referral.

• If a pending or complete referral for the same change exists: Do not submit a new one. Inform the member it is processing.

2. Check Program Status under programs> program instances in admin using members email or UUID to see  if program is marked Paused or Complete.

• Look for: Programs marked "Paused" or "Complete".

• The Issue: The "Request" feature logic cannot process members in these states; it will throw the request onto an overflow dash.

• Action: Do NOT use the tool. Escalate to Product Ops via JIRA on the ESCA board.

3. Check Current Coach Status

• Look for: Coach names listed as "Health Guide at Vida" or "Virtual Health Coach". in the Health Guide Platform.

• The Issue: This indicates the member is on a mystery/overflow dash. The system will not recognize this as a valid starting point.

• Action: Do NOT use the tool. Escalate to Product Ops via JIRA on the ESCA board.

Part 2: Program & Provider Configuration Guide

Use this chart to determine if a Provider (RD or CDCES) actually needs to be added before you submit a request. This prevents unnecessary manual adds.

Part 3: How to Submit a Request

Location: Changes are now accessible under Care Team > Requests within the HGP.

(Note: This functionality is not available for V-Chatbot or Social Groups).

Step 1: Access the Feature

1. Open the member's profile in the HGP.

2. Click the "Actions" button.

3. Click "Requests".

4. Select the Team you are making the request for.

Step 2: Select Type & Submit

1. In the Requests dialog, select the Type of Request (e.g., Change Program, Switch to Care Group, Add Guest RD).

2. Enter any additional information required.

3. Click Submit.

Step 3: Confirm Status

• Success: You will see a green success message. An automatic note is added to the member's profile.

  

• Rejection: You will see a red error message explaining why (see Troubleshooting table below).

Automatic Note: A note detailing the request submission and its immediate outcome is automatically added to the member’s notes section.

Part 4: Completion Timelines

Please set the correct expectations with the member regarding when the change will be visible.

Part 5: Troubleshooting & Escalations

If the request fails or fits a complex scenario, use this matrix to determine the next step.

How to Solve the Ticket:

1. If successful, use the macro: Member Requesting Program/Coach Switch - Processed.

2. Apply necessary tags.

3. Solve the ticket.