Payment Errors

When a member's monthly premium payment doesn't go through, the clock is ticking on their coverage. This campaign has the AI reach out, let them know a payment didn't come through, and get them on with your team to sort it out.

It's not a collections call. The tone is supportive and neighborly, a quick two-minute check-in. The AI never takes payment info itself, and it makes a point of telling members you'll never ask for it over the phone.

In the messages below, anything in brackets fills in for each member: [First name], [AI name] (whatever you've named your AI employee), [Agency], [Carrier], and [Agency phone] (your agency's number).

In the template picker, this one's called ACA Payment Errors.

At a glance

How people get in

There's no automation with this template, so you add people yourself, usually from a list of members with a failed payment. See Add Customers to a Campaign.

What the AI says

The campaign comes with three AI employees.

Daytime calls (the main one)

The call opens with:

Hey is this [First name] [Last name]?

Once they confirm, the AI introduces itself:

Ok cool so yeah I'm [AI name] I'm your assigned member care specialist with [Agency], oh and this is a recorded line. Do you have a quick sec?

Once they say yes:

sweet thanks, so I see here you've got a plan with [Carrier], and, and uh, I was giving you a call cuz it's showing that a recent payment didn't come through. You hear anything about that?

From there:

• They haven't paid. "oh yeah no worries at all. If you'd like, I can patch you through to someone who can help you knock this out right now." If they say yes, it transfers them: "alright, hang tight for just a sec, I'm gonna go grab an agent. One sec."
• They already paid. "oh nice okay, my system's probably just a little behind then. well hey thanks for staying on top of it, let me go ahead and make a note here." It logs a note for your team.
• They're confused. It slows down, breaks it into smaller pieces, and checks in: "am I making sense so far?"

Before it lets them go, it always says:

alright cool, oh and hey before I let you go I always gotta say, we'll never ask you for payment info over the phone. If someone does, that's probably a good sign that you should hang up.

Then it asks if they have your number, reads it if they need it, and signs off with "alright sweet well it was great chatting with you, take care."

It's also set up for:

• "Are you AI?" It's honest: "yeah so I'm actually an AI, but I've got your actual account pulled up right here so I can help out. is that ok?"
• "What's the issue?" "Yeah so it's just showing that a recent payment didn't come through, so your coverage could be affected if it doesn't get sorted out."
• They're skeptical it's legit. "oh yeah I totally get it. So yeah I'm not asking for any money or anything like that, I'm just calling to make sure you know about the payment and how to take care of it." If they still push, it tells them they can always call you directly to verify.
• They want to cancel, or have plan questions (copays, doctors, subsidies, networks). It never guesses and doesn't try to save it. It offers a transfer: "oh for sure - lemme get you on with one of our team members, they've got your plan details pulled up so they can walk you through everything. Okay if I transfer you here?."
• Busy right now. "oh yeah for sure no worries, when works better for you?"
• Someone else answers. It doesn't discuss plan details with anyone but the member.

After hours

When a member calls back after hours, the after-hours employee answers with "Thanks for calling [Agency], oh and this is a recorded line. Who do I have?" It explains that the team called earlier because a recent payment didn't come through. Since nobody's around to take a transfer, it offers to book a time with a licensed agent instead (or takes down what they need so your team calls back during business hours). It gives the same "we'll never ask for payment info" reminder before it hangs up.

Appointment callbacks

When an appointment comes up, what happens depends on your appointment configuration. If the AI makes the callback, it introduces itself as their assigned member care specialist, mentions the recorded line, says they had a callback scheduled, and checks that now still works. If it does, it transfers them: "alright cool, hang tight for just a sec, I'm gonna go grab someone from the team. One sec." If not, it rebooks and confirms the new time.

The cadence

Day 1: Call

Text, a couple minutes before the call:

Hey [First name], this is your care team at [Agency]. Got a quick update on your health coverage - giving you a call in just a sec.

Voicemail if they don't pick up:

Hey [First name], this is [AI name] with [Agency], just calling with an update about your health coverage. When you get a chance, give us a call back at [Agency phone]. Thanks!

If they didn't connect, this text goes out right after:

Hey [First name], we just tried reaching you about your [Carrier] plan - no worries! We'll try again in a bit.

Day 1, about 2 hours later: Call

Text, about 10 minutes before the call:

Hey [First name], it's us again - gonna try you one more time in about 10 min. It's about your health coverage.

No voicemail.

If they didn't connect:

We tried you a couple times today about your [Carrier] coverage. Give us a call back when you get a chance - this number works.

Day 2: Call

Text, a few minutes before the call:

Hey [First name], it's your care team at [Agency] - we've been trying to reach you about your health insurance plan. Giving you a call in a few.

Voicemail if they don't pick up: the same one as the first call.

If they didn't connect:

Hey [First name], we've tried you a few times now about your [Carrier] coverage - it's important. Please give us a call back when you get a chance.

Day 3: Call

No text before this one, and no voicemail.

If they didn't connect, one last text, and then the journey ends:

Hey [First name], we've been trying to reach you about your [Carrier] plan - a recent payment didn't come through and it could affect your coverage. Please call us at [Agency phone] so we can help you sort it out.

When they do connect

On any of the four calls, if they agree to pay or the call wraps up fine, they get this text and the journey ends:

Thanks for chatting with us! If anything comes up with your [Carrier] plan, you can always call us at [Agency phone].

If they say they can't afford it, are reluctant to pay, want to cancel, or are confused about their policy, they get this one instead, and the journey ends:

Hey [First name], thanks for taking the time to chat. If you need help with anything with your plan, our team's got you - just give us a call at [Agency phone].

How each call works

• If they're transferred to your team, they're done.
• If they agree to pay or the call wraps up fine, they get a thank-you text and they're done.
• If they can't afford it, are reluctant, want to cancel, or are confused, they get a "we've got you" text and they're done.
• If we can't reach them (no answer, voicemail, "call me later," or the call drops early), they get a text and move to the next try.
• If it's a bad number, they're stopped right away.
• If the AI books an appointment, transfers the call, or logs an inquiry, the journey ends right there. Booking an appointment ends all of that member's active campaigns.
• Do Not Call and invalid numbers stop right away.

Before you turn it on

• Set up your escalations in Employees > Escalations. Point Transfer Call at a transfer destination (this is the main move on this campaign) and Book Appointment at an appointment configuration. Inquiries don't need anything, they go to your Inbox and the Inquiries page and the member's assigned agent gets notified. The scripts can also look up plan benefits. You can't activate the campaign until Transfer Call and Book Appointment point somewhere.
• Register for SMS. This campaign texts, so you need SMS registration (10DLC) before the texts can send.
• Check your member data. The script needs first and last name, carrier, and effective date. Anyone missing one of those gets skipped, along with anyone who has no phone number, or no time zone or state.
• Add your members who missed a payment.
• Check your caller ID. Out of the box, this campaign calls from your agency's main number (the one your Receptionist answers), so make sure you have one. You can see this on the Phone Numbers tab: Use organization main number for outbound calls is switched on. Want it to call from its own number instead? Switch that off and add a number there (you can only change it while the campaign isn't active). See Managing Your Phone Numbers.
• Know when it calls. Calls and texts only go out during your business hours and between 8 AM and 9 PM in the member's time zone.
• Test it before you go live. See Test Your Campaign.

Then click Activate on the Overview tab. Until you do, the campaign is a Draft and nobody gets called.

Changing any of this

• What the AI says: the Employees tab. See Edit Your AI with Employees.
• Texts, voicemails, and timing: the Pulse tab. Click any call or text step to edit it. See Pulse.
• Who gets in: you add people yourself, or set up an automation on the Automations tab. See Automations Explained.