Network Change Alert

A careful heads-up call to Medicare members when a doctor they see may be leaving their plan's network, so they hear it from their agent's team and not the front desk.

Losing a doctor feels personal, and it's one of the big reasons people leave a plan. The worst way to find out is from the receptionist when you show up for an appointment. This campaign gets to the member first. The AI lets them know a network change might affect one of their doctors, finds out who they're seeing, and gets them to their agent to check where things stand.

The AI is careful here. Network data goes stale and contract disputes get worked out, so it never tells anyone flat out that they've lost their doctor, and it never tells them to find a new one. Notice the "might" in the script. That's on purpose.

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

At a glance


Who it's for	Medicare members who see a provider that's leaving, or has left, their plan's network
Goal	Let them hear it from their agent's team first, and get them a time with their agent
How people get in	You add them
Calls	Up to 2
Texts	Up to 4
Runs for	2 days
Escalations	Transfer, appointment, inquiry (and the AI can look up plan benefits)

How people get in

There's no automation on this one. You add people yourself. See Add Customers to a Campaign.

Who to add: members on a plan that just lost (or is about to lose) a provider, who see that provider, usually their primary doctor or a specialist. The AI doesn't get the doctor's name from careCycle. It asks the member who they're seeing and writes it down for their agent.

What the AI says

The campaign comes with three AI employees: one for daytime calls, one for after hours, and one for appointment callbacks.

Daytime calls (the main one)

The call opens with:

Hi, this is [AI name] with [Agent name]'s team at [Agency]. Am I speaking with [First name]?

Once they confirm, the AI gives the reason:

Oh hey [First name], so uh [Agent name] wanted me to reach out, we got a notice about a change to the doctors your plan covers and it looks like it might affect one of yours.

Then it lets them react and asks:

Who are you seeing these days? I just wanna make sure [Agent name] is looking at the right one.

It writes down the provider names they give. If they name the doctor that's changing, it doesn't confirm or deny it. It's collecting, not verifying. Then it's honest that it has a notice that something changed with the network, doesn't want to guess what it means for their doctor, and their agent can check exactly where it stands. It offers to book a time with their agent, or transfer them now if they'd rather sort it out while they're on the phone. If they want neither, it logs the providers for your team and lets them know they can call or text this number.

If they mention an appointment coming up, it suggests calling the doctor's office first to check they're still taking the plan. It only says this if an appointment actually comes up.

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

"So I'm losing my doctor?" It won't confirm that, because it doesn't know. It says something changed with the network and their agent can check exactly where it stands.
"Should I find a new doctor?" It never advises that. It routes it to their agent.
"Can I change plans because of this?" It doesn't explain enrollment rules, doesn't suggest switching, and doesn't imply they're stuck either. It notes that they asked and routes it.
They're upset. It acknowledges it once, plainly, then gets the doctor's name down and gets them to a person.
"Why is my doctor leaving?" Usually contract disputes between providers and carriers, but it doesn't know the reason for this one and won't take sides.
"I don't see that doctor anymore." It notes it so your records get corrected and keeps the call short.
They're in the middle of treatment with that specialist. It treats it as urgent, logs it that way, and tries to get them to a person now rather than a booked time next week.
"Are you a robot?" "I'm a virtual assistant, I help [Agent name] with client calls."
"Take me off your list." It confirms they'll be removed and lets them go.

After hours

Same conversation, but nobody's around to take the call live. So instead of a transfer or booking, it lets them know nobody's at their desk right now, takes down their doctors and questions, and makes sure their agent follows up. If someone calls in after hours, it lets them know nobody can take the call live and collects the same details.

Appointment callbacks

When an appointment comes up, this employee makes the callback. It mentions the recorded line, says it's calling on behalf of their agent about their scheduled appointment on their [Carrier] plan, checks that now still works, and transfers them to the team. If now's bad, it finds a new time on your calendar and books it. It doesn't get into doctor or network questions on this call, it just gets them to the person who can.

The cadence

Day 1: Call

Text, a few minutes before the call:

Hey [First name], it's [Agency]. [AI name] is giving you a ring in a minute about a network update on your [Carrier] plan. Quick one!

Voicemail if they don't pick up:

Hi [First name], it's [AI name] at [Agency], I work with [Agent name]. There's a network update that may affect your [Carrier] plan, and we want to check whether it touches any of your doctors. These things do get worked out sometimes, so there's nothing to act on yet. Give us a call back at [Agency phone] when you get a minute.

Day 1: Text (if we didn't reach them)

Sorry we missed you just now. Nothing urgent, we just want to go over a network update on your [Carrier] plan with you. We'll try you again.

Day 2: Call

Text, a few minutes before the call:

[First name], [AI name] again from [Agency]. Trying you once more in a couple minutes on that [Carrier] network update. Nothing you need to do ahead of it.

Voicemail if they don't pick up: the same one as Day 1.

Day 2: Text (if we didn't reach them)

Looks like we keep missing each other, no worries. Anytime you want us to take a look at the doctors on your [Carrier] plan, call [Agency] at [Agency phone] and we'll walk through it with you.

After that, the journey ends.

How each call works

If they get transferred, book an appointment, or the AI logs an inquiry, they're done. The journey ends right there. Booking an appointment ends all of that member's active campaigns.
If they talk to the AI, they're done too, whether the call wraps up normally, they're confused about their policy, or they ask to cancel.
If we can't reach them (no answer, voicemail, "call me later" without booking, or the call drops right away), they get the follow-up text and move to the next call.
If it's a bad number, or they ask not to be called, they're stopped right away.

Calls and texts only go out during your business hours and between 8 AM and 9 PM in the member's time zone.

Before you turn it on

Set up your 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 go to your Inbox and the Inquiries page automatically, and that's where the doctor names show up.
Check your member data. The AI needs each member's first name, last name, carrier, and assigned agent, plus your agency name. People missing any of these get skipped, and so does anyone without a phone number or a time zone or state.
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.
Get SMS registration done so the texts can go out. See SMS and RCS Registration.
Test it. See Test Your Campaign.
Click Activate on the Overview tab, then add your members.

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 call or text step to edit it. See Pulse.
Who gets in: you add people yourself. If you'd rather have them come in automatically, set it up on the Automations tab. See Automations Explained.