Script
Verbatim scripting directly after rapport building.
What is the Scope of Appointment?
Health care option run by the Federal government that combines Part A & B
What is Original Medicare?
Medicare enrollment periods where beneficiaries can change their plan.
What are the AEP, OEP and SEP?
A Medicare option that covers everything that Original Medicare covers, plus offers additional benefits
What is Medicare Advantage (MAPD)?
The name of the carrier that we sell our add-ons with.
What is Aetna?
The set of letters and numbers you need to enter to bring up a previous client.
What is Personal Code?
The portion of the script where you would go to CMS.
What is Qualification?
Inpatient hospital, skilled nursing, hospice and home-health care services
What are services covered by Medicare Part A?
The website where you check for qualification.
What is CMS (MARx)?
The parts of Medicare a beneficiary needs to have in order to enroll in a Medicare Advantage plan.
What is Medicare Part A & Part B?
The tool used to help maintain compliance standards.
What is the Audit Tool?
The first piece of information to enter on Sunfire.
What is Zip/Postal Code?
The acceptable answer from a client after reading each question of the confirmation statement.
What is a clear yes?
The approximate percentage of costs that Part B of Original Medicare does not cover.
What is 20%?
When we inform the client of their SEP.
When is during the Enrollment/Qualification?
The type of Medicare Advantage plan that allows flexibility for in- and out-of-network coverage.
What is a Medicare Advantage PPO plan?
The availability that you set Convoso to after the client is off the line after a successful sale.
What is Training?
The 3rd party person who confirms the client understands their plan after enrollment is complete.
Who is a Sunfire Advocate?
The fill-in-the-blank section at the end of the script post sale.
What is the App Info Section?
The phase where members pay a higher % of their drug costs until they reach their OOP threshold.
What is the "donut hole" or coverage gap?
The carrier that does not accept the FEMA SEP code.
What is WellCare?
A veteran who uses the VA Pharmacy for their Part D needs would have this type of Medicare plan.
What is Medicare Advantage without prescription coverage (MA Only)?
The orange button on the transfer window.
What is Leave Conference Call?
The carriers that we transfer to the Sunfire Advocate line.
What are all carriers?
The 711 number required to be given at the end of a sale.
What is Touch Tone Users? (Teletypewriter, number for people who are hard of hearing.)
The period of time each year, from Oct 15 - Dec 7, when members can change their Medicare Advantage plan.
What is the Annual Election Period (AEP)?
This is required before running the MARx information.
What is verbal consent?
The PD at the end of MAPD.
What is Prescription Drug Coverage?
The required screen shots post sale.
What are Doctors, Medications, and the Comparison?
This feature is similar to CMS and Humana LIS Check.
What is the Sunfire Real-time Customer Lookup?
5 pieces of required information to properly present drug cost.
What is annual drug cost, tier, coverage period, monthly cost, and any restrictions?
The standard Part B premium for 2023
What is $164.90?
The code used for the gain, loss, or change in LIS-Eligible Status.
What is NLS?
The included benefit that puts a cap on yearly spending.
What is Maximum Out Of Pocket (MOOP)?
The website you go to when your client does not have LIS but may qualify.
What is SSA (Social Security Administration)?
The pieces of information required for a compliant verbal signature.
What are Name, Date of Birth, and a clear "I Agree"?
Any 5 Core Benefits.
What are Premium, Doctor, Specialist, Inpatient Hospital, Out Patient Hospital, Mental Health Services, MOOP, Dental, Vision, Hearing, Pharmacy, Additional Benefits,
A standardized type of Medicare plan that can be purchased along with Original Medicare to cover gaps.
What is a Medigap (Medicare Supplement) plan?
The client has no SEP and does not qualify for LIS.
What is transition to add-ons and VBC?
The frequency at which someone can make an LIS SEP switch.
What is once per quarter (not quarter 4)?
The only acceptable place to check if a doctor is not in network on Sunfire.
What is the Carrier Website?
The place we check when a client asks a question that is not covered in the plan comparrison.
What is the Summary of Benefits?