English for Call Centers | Training for Customer Service Agents: Handling Customer Inquiries

call center insurance company role play
call number one
call center agent
and customer
hello thank you for calling single step
Insurance my name is Nicole how may I
assist you today
hi I'm interested in enrolling in a new
health insurance plan
can you tell me about my options
absolutely I can help you with that we
have a variety of plans to choose from
including plan a plan B and plan C
which type of coverage are you looking
for
not sure can you tell me a little bit
about the differences between the plants
sure
plan a is a high deductible plan with
lower monthly premiums Plan B is a
mid-range plan with moderate deductibles
and premiums
plan C is a comprehensive plan with low
deductibles and higher premiums
okay that's helpful it seems like plan C
would be best for me can you tell me a
little more about that plan
plan C covers a wide range of medical
services including preventative care
doctor's visits and prescription
medications it also has low
out-of-pocket costs the monthly premium
is higher than the other plans but it
may be a good choice if you anticipate
needing a significant amount of Medical
Care in the future
that sounds good
can I enroll in this plan online
yes you can enroll in a new plan online
through our website if you have any
questions or need assistance with the
enrollment process you can also call our
customer service line and one of our
agents will be happy to help you okay
thank you I think I'll go ahead and
enroll online
great if you have any questions or need
assistance during the enrollment process
please don't hesitate to call us back we
are here to help thanks I'll keep that
in mind goodbye you're welcome have a
great day
call center insurance company call
number two
call center agent
and customer
hello thank you for calling single step
Insurance my name is James how may I
help you today
hi I'd like to know what kind of
doctor's visits and surgical procedures
are covered under my plan
also what percentage do I have to pay
for those visits or procedures
I would be happy to assist you with that
could you provide me with your policy
number so I can pull up your specific
plan details
sure it's 8433-5021
thank you for that Ms Buford I see that
you are enrolled in the basic plan which
covers preventative care at 100 percent
and most other medical procedures at 80
percent after the deductible has been
met
okay thank you for that so if I need a
procedure that costs ten thousand
dollars and my deductible is one
thousand dollars then I'll pay one
thousand dollars and my insurance will
cover the remaining amount that's
correct however it's important to note
that some procedures may not be covered
under your plan such as elective or
experimental procedures
I see is there any way to find out the
costs of a specific procedure in advance
we can provide you with estimated costs
for a procedure before it takes place
but you will need to confirm actual
costs with your care provider
you can request a cost estimate by
logging into your account on our website
and following the prompts or by calling
our customer service line
it's a good idea to get a cost estimate
in advance so you can have a better
understanding of your financial
responsibilities
yes that's a good point thanks for your
help that gives me a much better idea
about the billing process
you're welcome if you have any other
questions or concerns please don't
hesitate to call us back have a great
day
call center insurance company call
number three
call center agent
and customer
hello thank you for calling single step
Insurance my name is Erica how may I
assist you today hi I received a notice
that a claim I submitted was denied I
want to appeal the decision can you tell
me how to do that
of course I'd be happy to help you with
that can you provide me with your policy
number and the date of the claim in
question sure my policy number is 1943
-08-455 and the date of the claim was
let me confirm this yeah it was December
15th
thank you for that information
I see that the claim was denied because
the medical procedure in question was
classified as elective surgery which is
not covered under your insurance plan
but I believe this was a medically
necessary procedure
therefore I want to appeal the decision
D you have the right to appeal any
denied claim or coverage decision to do
so you'll need to submit a written
request for appeal along with any
supporting documentation such as a
letter from your doctor explaining the
medical necessity of the procedure
you can download the appeal form from
our website
okay I'll plan on doing that could you
tell me what happens after I submit the
appeal
after you submit the appeal our claims
department will review your case and
determine whether the charges are
covered under your plan
we'll notify you of the decision in
writing if the appeal is successful and
the charges are covered you'll receive
an adjusted medical invoice that will
show your refund amount if the appeal is
denied you'll receive a letter
explaining the reasons for the decision
all right I understand
thank you for explaining all that you're
welcome if you have any other questions
or concerns please don't hesitate to
call us back have a nice day
call center insurance company call
number four call center agent
and customer
hello thank you for calling single step
Insurance my name is David how may I
assist you today
hi I need to add my new baby to my
health insurance plan how do I do that
congratulations on your new addition
adding a dependent to your plan is a
simple process first you'll need to
provide proof of the new dependent's
relationship to you
such as a birth certificate or adoption
papers you can do this by logging into
your account on our website and
uploading the documents or by mailing
them to our office
okay I'll do that how long does it take
for the new dependent to be added to the
plan
once we receive the necessary
documentation it typically takes about
five to seven business days for the new
dependent to be added to the plan
in the meantime you can add your new
dependent to your insurance card by
calling our customer service line and
requesting a temporary ID number
this can be used to obtain medical care
until the permanent ID card is issued
okay that's good to know
I was just wondering in the future what
if I need to remove a dependent from my
plan
okay if you need to remove a dependent
from your plan you can do so by logging
into your account on our website and
following the prompts or by calling our
customer service line in speaking with
an agent you'll need to provide the name
and policy number of the dependent you
wish to remove
please note that dependents can only be
removed from a plan during the annual
enrollment period or due to a qualifying
life event such as a divorce or a
dependent reaching the age of 26.
okay I understand I wasn't sure about
the dependent age thing thank you so
much for your help
you're welcome if you have any other
questions or concerns please don't
hesitate to call us back have a great
day
thank you you too
thank you again for calling single step
Insurance goodbye
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