Approval Calls

This one's the good-news call. When a member's Medicare application gets approved, the AI calls to tell them they're in, when coverage kicks in, and when their card should show up. If it can't reach them, it tries again a few hours later, then once more the next day.

In the template picker, this one's called MA Approval Calls.

It's part of the Retention Journey, the set of templates that follow a member through their first year. Unlike most of the others, it doesn't add anyone on its own. You add members when their application is approved.

In the messages below, anything in brackets fills in for each member: [First name], [Last name], [AI name] (whatever you've named your AI employee), [Agency], [Agency phone] (your number), [Carrier], [Agent name] (the member's agent), and [effectiveDate] (the date their coverage starts).

At a glance

How people get in

This template doesn't come with an automation, so nobody gets in until you add them. Add members once their application is approved. 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:

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

Once they confirm, the AI goes straight to the good news. The opener is shaped like this:

Oh awesome - yeah so this is [AI name] I work with [Agent name] at [Agency], and oh uh this is a recorded line, but yeah so I'm calling cuz I've got some good news - your uh, your [Carrier] application went through, you're all set. And your coverage kicks in [effectiveDate]. Did you hear about that?

Then it walks through next steps one at a time, waiting between each:

• Their card should show up in about five to seven business days: "So, your insurance card should arrive in about five to seven business days. Do you think you'll be needing the card for any reason before then?"
• Coverage is live on the start date, card or no card.
• If they need a doctor before the card arrives, the office can look them up with the start date and plan info.

It answers what it can on its own (plan name, carrier, start date, card timeline, using coverage before the card arrives, your number). Anything it's not sure about, or anything medical, claims-related, or high-stakes, gets logged for the agent: "yeah so I wanna make sure you get the right answer on that one, so let me have [Agent name] give you a call and go over it cause they can pull up all the details"

It's also ready for the stuff people say on these calls:

• "Are you AI?" It's honest: "yeah I mean technically yeah, I'm an AI - but I've got your actual approval details right in front of me, this isn't a generic call."
• Thinks it's a telemarketer. It leans on details only you'd know, and offers your number so they can verify: "if you wanna verify you can always just call us directly at [Agency phone]."
• It's a renewal or plan change. It reassures them there's no gap in coverage.
• The approval came with a condition. It says there's one thing to take care of before it's fully active, and hands the details to the agent instead of guessing.
• Wants to see details before the card arrives. It points them to the carrier's member portal.
• Wants a real person. It gives them the agent's number, or gets them over to someone if now works.
• Busy right now. It respects that right away, offers a callback at a better time, and doesn't squeeze in "one quick thing."
• Someone else answers. It asks for the member and doesn't discuss plan details with anyone else.

After hours

When members call back after hours, the after-hours employee picks up. It figures out whether they're returning a missed call or already heard the news, and goes from there:

oh hey yeah thanks for calling back - so this is [AI name] I work with [Agent name] at [Agency], and oh uh this is a recorded line, but yeah so I've actually got your info pulled up here and it looks like your [Carrier] application went through, so that's great news. Did you already hear about that?

Same next steps as the daytime call. It's upfront that the office is closed, so anything it can't answer, or anyone who wants a real person, gets booked for a time with the agent: "yeah so the office is closed right now, but I can totally get you set up with a time for [Agent name] to call you back - what works best?" For truly urgent medical stuff, it points them to the number on their current insurance card or urgent care.

Appointment callbacks

When an appointment comes up, what happens depends on your appointment configuration. If the AI makes the call, the appointment callback employee opens with:

Hi [First name], this is [AI name] from [Agency] calling for your scheduled appointment with our team. Is now still a good time?

If yes, it transfers them to your team. If not, it books a new time and makes sure they have your number.

The cadence

Day 1: Call

Text, a couple of minutes before the call:

Hi [First name], this is [Agent name]'s team at [Agency] - we've got some good news about your [Carrier] application! Giving you a call here in a sec.

Voicemail if they don't pick up:

Hi [First name], this is your care assistant from [Agency] calling with good news about your recent [Carrier] enrollment. Please call us back at this number when you get a chance.

If they don't pick up, they get this text:

Looks like we missed you - no worries! We'll try you again a little later. Just so you know - we've got good news about your [Carrier] application whenever you're free. You can also call us anytime at [Agency phone].

Day 1, about 4 hours later: Call

Text, a couple of minutes before the call:

Hi [First name], it's [Agency] again - still trying to reach you with an update on your [Carrier] plan. Calling you now!

Same voicemail as before. If they don't pick up:

Ah missed you again - we'll give it one more try. We really do have good news about your [Carrier] plan! Or if it's easier, just give [Agent name] a call at [Agency phone] whenever works.

Day 2: Call

Text, a couple of minutes before the call:

Hey [First name], last try from [Agent name]'s team - your [Carrier] application got approved and we want to make sure you've got all the details. Calling you now, but you can always reach [Agent name] at [Agency phone].

Same voicemail. If they still don't pick up, they get one last text and the journey ends:

Hey [First name], we've been trying to reach you with good news - your [Carrier] application was approved! Your coverage starts [effectiveDate]. Give [Agent name] a call at [Agency phone] when you get a chance and they'll walk you through everything.

Whenever they do talk to the AI, they get this recap text and the journey ends:

Hey [First name], great chatting with you! Just a reminder - your [Carrier] coverage kicks in [effectiveDate] and your card should arrive in 5-7 business days. If anything comes up, give [Agent name] a call at [Agency phone].

How each call works

• If they talk it through with the AI, they get the recap text and they're done.
• If they don't pick up, the call drops right away, or it's a bad time, they get a missed-you text and move to the next call.
• If they book an appointment, get transferred, or the AI logs an inquiry, the journey ends right there.
• If it's a wrong number or a bad number, or anything else comes up, the journey ends.

Before you turn it on

• Escalations. In Employees > Escalations, point Transfer Call at a transfer destination and Book Appointment at an appointment configuration. The campaign can't be activated until both point somewhere. Inquiries need nothing, they show up in your Inbox and on the Inquiries page.
• Member data. The scripts need first and last name, carrier, and effective date. Members missing any of that, or missing a phone number or time zone, get skipped. The texts also use the member's agent, so make sure your members have one assigned.
• SMS registration. Texts don't send until your number is registered (10DLC). See SMS and RCS Registration.
• Timing. Calls and texts only go out during your business hours and between 8 AM and 9 PM in the member's time zone. See Business Hours and Holidays.
• Test it. Call yourself first. See Test Your Campaign.
• Activate. A new campaign starts as a Draft. Nobody's contacted until you click Activate on the Overview tab.

Changing any of this

• What the AI says on calls: the Employees tab. See Edit Your AI with Employees.
• Texts, voicemails, and timing: the Pulse tab. Click any step to edit it. See Pulse.
• Who gets in: the Automations tab. This template doesn't come with one. See Automations Explained.