EMS Call Intro

Intro:

“Thank you for calling Medicare USA at Health Plan One. My name is [agent], how may I help you?”

  1. The EMS agent will respond: “Yes, I am calling from Enhanced Medication Services with a patient from one of our partner pharmacies. I have permission from the patient to provide you with their information. May I provide that to you now?”
  2. You will say “Yes” and then the EMS agent will provide:
    • The patient's name
    • The patient's phone number
    • The patient's zip code
    • The patient's pharmacy NPI number
    • The pharmacy name and address
  3. You will say: “Just to confirm I have the information right I will repeat it back to you:
    • The patient’s name is [patient name]
    • The patient’s phone number is [phone number]
    • The patient’s zip code is [zip code]
    • The patient’s pharmacy NPI number is [NPI Number]
    • The pharmacy's name and address is [Pharmacy Address]”

Important:

Make sure you get the name and address of the pharmacy when the EMS gives you the NPI code.

Medicare Quoting Tool
  1. EMS Agent will confirm the info is right.
  2. You will respond: Thank you for providing that information, I will be happy to discuss Medicare plans with Mr./Mrs. [Patient first name] [Patient last name]. Thank you for introducing us I can take the call from here.
  3. The EMS agent will thank the patient and remind them to stay on the line to talk with the HPOne agent.
  4. After the call is successfully transferred from the EMS Agent, for completeness purposes, you will reiterate the patient’s authorization during the initial part of an outbound call as follows: “Mr./Ms. [Last Name], can you confirm that you provided your authorization to speak with us today about Medicare plan options?”
    [YOU MUST RECEIVE A VERBAL ‘YES’ TO PROCEED WITHOUT FOLLOWING THE “NO” PATHWAY BELOW]
    If YES, the HPOne Agent will proceed with the HPOne script
    If NO: “That’s OK, we can go through those disclosures together now to get your permission for us to continue talking”:
    • Please confirm the following things by saying YES or I AGREE after I have read both of these statements to you:
      1. Do I have your consent to continue this call at this number and discuss possible health insurance plans?
      2. Do you understand that your consent to discussing these plans in this way is not required as a condition of purchasing any goods or services from your pharmacy?
  5. Once the patient agrees, you can proceed with the HPOne script.

IMPORTANT:

When you are ready to start the selling process, you must ask the patient:

Are you interested in keeping [pharmacy name] as your preferred pharmacy?


Quoting Tool

Since you entered the NPI into Quoting Tool, that pharmacy's preferred plans will be highlighted with the Preferred Pharmacy Icon:

Pharmacy Preferred Plan

Plans with this icon should be discussed first. If no preferred plans meet their needs, agent can ask the customer if they would like to explore additional plans.

The plans in the Quoting Tool will now be sorted by Estimated Annual Cost.

You’ll be able to let the patient know which plans have the lowest out-of-pocket cost for the year.