Call script builder

Who are you calling, and why?

• Phone script: ask for a peer-to-peer reviewWhat to say to your doctor's office and your plan to ask for a call between your doctor and the plan's reviewing physician.
• Phone script: ask for reprocessingWhat to say to your plan and to the provider's billing office to get a paperwork denial corrected and the claim processed again.
• Phone script: call your regulatorWhat to ask when you call the agency that oversees your plan, so you learn which agency is right and how to file a complaint.
• Phone script: chase an appeal that has gone silentWhat to say and ask when you have filed an appeal and heard nothing, including the federal decision deadlines for job-based and individual plans.
• Phone script: first call after a denialWhat to say and ask on your first call to your plan after a denial, and what to write down before you hang up.
• Phone script: talk to human resourcesWhat to ask your employer's benefits or human resources office to learn who runs your plan and to get the plan documents.
• Phone script: appeal to your Medicaid plan and keep services goingWhat to say when you phone your Medicaid health plan to appeal a cut or ending of services and keep them going during the appeal, what to ask for, what to do if told the provider must ask, and what to write down.
• Phone script: ask Medicare for a fast appeal when care is endingWhat to say when you phone the Medicare quality reviewer to ask for a fast appeal because a hospital stay, nursing facility, rehabilitation or home health care is ending, and what to write down. For Original Medicare and Medicare Advantage.
• Phone script: pharmacy rejectionWhat to ask at the pharmacy counter and then your plan when a prescription is rejected, so you learn why and what to send.
• Phone script: first call to the billing office about a surprise billWhat to say on your first call to a provider's billing office about a bill that may be a surprise bill: what to ask for, what to write down, how to ask for a hold in writing, and what to say if they mention collections.
• Phone script: three-way call with your providerHow to bring your doctor's office onto a call with your plan so that both sides hear the same facts and agree on what happens next.