Every OEV Call Should Be a Welcome Call

May 23, 2013
|In Compliance, Agent Oversight
|By GHG Advisors

In the world of insurance sales, making the right call during a sales presentation and getting the call right for compliance purposes is critical.  Outbound Enrollment Verification calls (OEV) calls are not just for an applicant’s protection — they’re the insurance industry’s version of instant replay!

Verification calls are “welcome calls” with a new member.  A verification representative should be on every OEV call. Just because OEV calls are a CMS requirement does not mean verification specialists should just “check the box” and read the questions in a Ben Stein-monotone.

Remember, all plan sponsors are required to conduct OEV calls for enrollments originating from both independent and employed agents/brokers to ensure applicants understand the plan’s rules.

Here are some other tips to ensure a plan sponsor makes the most out of every OEV call:

    • WRITE YOUR OWN SCRIPT: The OEV call is your first call with a new member following enrollment. It’s important to create a natural, personable script to make a favorable first impression. A good OEV script should flow comfortably.
    • STAY POSITIVE, WARM AND ENGAGING: Verification calls are often a customer’s first point of contact since their enrollment. It’s important that OEV agents help to put their company’s best foot forward. Verification agents should use a warm tone and shouldn’t shy away from emphasizing their company’s brand.  Use the opportunity to engage the member.
    • EMPLOY A COHESIVE PROCESS: Some plans face challenges with OEV calls because their process is disjointed. Instead, work to create internal automation that pushes the calls and letters when necessary, or partner with a vendor that can do it for you.
    • CONDUCT OEV CALLS ASAP: Make CMS-mandated OEV calls as soon after the enrollment as possible. (OEV calls must be made to an applicant after the sale; they cannot be made at the point of sale.) Make the call sooner rather than later.
    • ARM OEV AGENTS WITH RESOURCES: Plan sponsors should ensure their verification agents have a strong knowledge base of plan details like doctors and hospitals in the network (if applicable), the co-pays for different prescriptions and the maximum out-of-pocket. In short, verification agents should be well-trained and have access to resources.
    • IT ALL STARTS AT ENROLLMENT! The enrolling agent can help the OEV process by setting expectations. Our Bloom phone and field agents explain applicants what the OEV process is, when to expect the call and what to expectduring a call. Enrolling agents should stay connected with OEV agents to ensure a healthy level of coordination and cooperation.

Remember, you get only one chance to make a first impression — and that impression begins with the OEV call!

Resources:

The Bloom Call Center is licensed in 48 contiguous states and offers marketing, call center and technology solutions to the health care industry.  Since 2007, Bloom has participated in over 55 million conversations about insurance products, submitted over 200,000 applications for insurance, and set over 150,000 appointments for seniors to meet with Licensed Agents.  Bloom is a proud partner of Gorman Health Group.  Click here to learn more.

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