Call Simulation Game

Patient Hesitancy Practice

• Scheduling Call Script
• Patient Hesitancy Notes

Click the arrow to start!

Read the following scheduling call scenarios and select the best responses to handle patient hesitency! Use the following tools to help determine the best options:

Choose the best reply:

I appreciate you calling but I have enough of my breathing meds.

Hi, Ms. Fosters. I'm calling because it's time to schedule your breathing medications Yupelri, Budesonide, Formterol, and Disposable Cups & Tubing prescribed by Dr. Johns and wanted to confirm that 61598 Eureka Rd is the correct address?

No problem! We will call you next month.

How much of the Yupelri, Budesonide and Formoterol do you have left?

Yes, speaking.

Hello! This is Mary calling from your pharmacy DirectRx. Is this Ms. Diana Fosters I am speaking with?

Alert: 8/15/24: $0 Copays. Med B Primary, ded met. AARP Plan F Supp covers coins/ded. APP Order: Yupelri, Budesonide, Formoterol and Disposable Cups & Tubing

Patient A: Diana Fosters

GREAT JOB!Always make sure to confirm the quantity patient has on hand. Often patients think they have more than they should when scheduling the next delivery. We anticipate they should have around 1 week supply left.

Ah ok, well go ahead and send it out!

That is about what we would anticipate; it takes about 3-5 days to ship to you so we can ship it out today to ensure you will get it in time.

I have about a week left!

How much of the Yupelri, Budesonide and Formoterol do you have left?

Alert: 8/15/24: $0 Copays. Med B Primary, ded met. AARP Plan F Supp covers coins/ded. APP Order: Yupelri, Budesonide, Formoterol and Disposable Cups & Tubing

Patient A: Diana Fosters

Ok! You guys are so wonderful there. Thank you!

No problem! We will call you next month.

Alert: 8/15/24: $0 Copays. Med B Primary, ded met. AARP Plan F Supp covers coins/ded. APP Order: Yupelri, Budesonide, Formoterol and Disposable Cups & Tubing

Patient A: Diana Fosters

Always make sure to confirm the quantity patient has on hand. Often patients think they have more than they should when scheduling the next delivery. We anticipate they should have around 1 week supply left. This eliminates shortages or the expense of last minute rushes!

1 month later....

I am glad you called. I really need my meds. I haven't had any in 3 weeks. You need to rush this out now!!

Hi, Ms. Fosters. I'm calling because it's time to schedule your breathing medications Yupelri, Budesonide, Formterol, and Disposable Cups & Tubing and wanted to confirm that 61598 Eureka Rd is the correct address?

Yes!

Try Again!

Hello! This is Mary calling from your pharmacy DirectRx. Is this Ms. Diana Fosters I am speaking with?

Alert: 8/15/24: $0 Copays. Med B Primary, ded met. AARP Plan F Supp covers coins/ded. APP Order: Yupelri, Budesonide, Formoterol and Disposable Cups & Tubing

Patient A: Diana Fosters

Choose the best reply:

That can't be right. That's so expensive!

Do we have your permission to charge the card on file for your $279.44?

That's my address... go ahead and send them.

Hi, Mr. Petricaj. I'm calling because it's time to schedule your breathing medications for Yupelri and Disposable Cups & Tubing prescribed by Dr. Lourdes and wanted to confirm that 615 E 2nd Ave is the correct address?

Let's double check that we have the right information on file! Is your insurance Medicare-Part B Primary?

We have billing and insurance specialists here who ensure this is the lowest possible cost. It's typically $1,100 without insurance so your plan is covering the majority of the cost.

Yes, this is him!

Hello! This is Ann calling from your pharmacy DirectRx. Is this Mr. George Patricaj I am speaking with?

Alert: 8/10/23: $278.44 Yup, $0.60 CT, $0.40 Filter. Medicare Part-B Primary Order: Yupelri, Disposable Cups & Tubing

Patient B: George Petricaj

We have billing and insurance specialists who ensure that this is the lowest possible cost. It's typically $1,100 without insurance so your plan is covering the majority of the cost.

Choose the best reply:

I understand....

... these medications can be costly. It is important to follow your doctor's regimen. Is it possible for you to try it for the month or is there anyone that can assist you with the costs?

... these medications can be costly. We can call you back in 3-4 weeks to see if maybe you are able to figure out another option?

It's still too much. I can't afford that on my monthly income.

Alert: 8/10/23: $278.44 Yup, $0.60 CT, $0.40 Filter. Medicare Part-B Primary Order: Yupelri, Disposable Cups & Tubing

Patient B: George Petricaj

When patients indicate they cannot afford medication, we must do our best to show compassion and offer every option possible. It is important to help the patient figure out if there are any other options such as getting help from a family/friend for the month or even getting at least one of the medications (if there are multiple medications on order). This patient may be eligible for funding or there may be another regime more cost effective that their doctor can prescribe.

I understand these medications can be costly. We can call you back in 3-4 weeks to see if maybe you are able to figure out another option?

I understand Mr. Petricaj. However if anything changes please feel free to give us a call, otherwise we will call in 3-4 weeks and check in with you.

Try Again!

Okay, I won't have the funds then either though.

Alert: 8/10/23: $278.44 Yup, $0.60 CT, $0.40 Filter. Medicare Part-B Primary Order: Yupelri, Disposable Cups & Tubing

Patient B: George Petricaj

... these medications can be costly. We can call you back in 3-4 weeks to see if maybe you are able to figure out another option?

Choose the best reply:

I understand...

Ah that's true. But still I can't afford that.

Yes, a premium is paid monthly for your insurance services. However this plan also has a coinsurance which you are responsible for. The Yupelri without this plan is about $1,100 so your insurance is covering almost 80% of the cost.

It is important to follow the treatment plan prescribed by your doctor. I am concerned if you stop taking it. Is there someone that could help you this month to try it out? We also work with funding foundations that may be able to help on future orders with your copay.

Yes, and I pay monthly for it!

Let's double check that we have the right information on file. Is your insurance Medicare-Part B primary?

Alert: 8/10/23: $278.44 Yup, $0.60 CT, $0.40 Filter. Medicare Part-B Primary Order: Yupelri, Disposable Cups & Tubing

Patient B: George Petricaj

GREAT JOB!Applying for funding may be the last available option for the patient. Also, be sure to remind them to let their doctor know they are not taking their medications due to budget concerns and encourage them to find out if there are any other more cost effective options available.

Yes, sounds good.

Great!

We need information from you in order to apply for funding assistance. There may be waitlists for funding, but we will do our best to get you any assistance available. Do you have a few minutes to answer some questions so we can get the application started?

Yes, COPD

Have you ever been diagnosed with COPD or Asmtha by a doctor?

I don't have anyone that can help. If you know anything that can help with the payment I will take it.

It is important to follow the treatment plan prescribed by your doctor. I am concerned if you are not taking it. Is there someone that could help you this month to try it out? We also work with funding foundations that may be able to help on future orders with your copay.

Alert: 8/10/23: $278.44 Yup, $0.60 CT, $0.40 Filter. Medicare Part-B Primary Order: Yupelri, Disposable Cups & Tubing

Patient B: George Petricaj

Mr. Yanes. It looks like you should be running low. What's changed in your treatment plan?

Choose the best reply:

That's my address but I don't need any right now..

Hi, Mr. Yanes. I'm calling because it's time to schedule your breathing medications for Yupelri and Disposable Cups & Tubing prescribed by Dr. Meridian and wanted to confirm that 394 Potomac Dr is the correct address?

Speaking!!

Hello! This is Ann calling from your pharmacy DirectRx. Is this Mr. Henry Yanes I am speaking with?

How much of the Yupelri do you have?

Alert: 4/01/24: $0 Yup, $0.60 CT, $0.40 Filter. Medicare Part-B Primary, Plan F AARP Order: Yupelri, Disposable Cups & Tubing

Patient C: Henry Yanes

It looks like you should be running low, Mr. Yanes. How often are you taking the medication?

Choose the best reply:

I have over a month left. Please call me then!

How much of the Yupelri do you have left?

Have you been taking the medication as prescribed?

Alert: 4/01/24: $0 Yup, $0.60 CT, $0.40 Filter. Medicare Part-B Primary, Plan F AARP Order: Yupelri, Disposable Cups & Tubing

Patient C: Henry Yanes

I am glad to hear you're back home now. We will call back in about 3 weeks to check in on you and schedule the next delivery.

GREAT JOB!It is important to find out how much medication a patient has; explain they should be running low in stock if they have more than 1-2 weeks and attempt to find out what has changed. Open ended questions are a great way to get more information from a patient when needed!

Great!

I take the Yupelri every day and it works wonders! I was in the hospital for about 3 weeks and just got out last week so I still have a lot left!!

It looks like you should be running low, Mr. Yanes. How often are you taking the medication?

Alert: 4/01/24: $0 Yup, $0.60 CT, $0.40 Filter. Medicare Part-B Primary, Plan F AARP Order: Yupelri, Disposable Cups & Tubing

Patient C: Henry Yanes

It looks like you should be low in stock now. Has anything changed in your treatment plan?

Choose the best reply:

Yes, of course. Just give me a call next month. I do not need any right now.

Have you been taking the medication as prescribed?

It is important to take your medication regularly; so it can build up in your system. We recommend following your doctor's instructions for best results which is to take the Yuperli once daily.

Alert: 4/01/24: $0 Yup, $0.60 CT, $0.40 Filter. Medicare Part-B Primary, Plan F AARP Order: Yupelri, Disposable Cups & Tubing

Patient C: Henry Yanes

It is important to find why the patient has more medication left than anticipated. Most patients will say "Yes" if you ask if they are following their provider instructions so it is best to use open ended questions to determine their current usage/habits.

PATIENT HANGS UP

I already know that. Just call me next month.

It is important to take your medication regularly; so it can build up in your system. We recommend following your doctor's instructions for best results.

Try Again!

Alert: 4/01/24: $0 Yup, $0.60 CT, $0.40 Filter. Medicare Part-B Primary, Plan F AARP Order: Yupelri, Disposable Cups & Tubing

Patient C: Henry Yanes

It is important to find why the patient has more medication left than anticipated. Most patients will say "Yes" if you ask if they are following their provider instructions so it is best to use open ended questions to determine their current usage/habits.

PATIENT HANGS UP

No I am all good. Just call me next month.

It looks like you should be low in stock now. Has anything changed in your treatment plan?

Try Again!

Alert: 4/01/24: $0 Yup, $0.60 CT, $0.40 Filter. Medicare Part-B Primary, Plan F AARP Order: Yupelri, Disposable Cups & Tubing

Patient C: Henry Yanes

Alert: 3/01/24: $0 Ohtuvayre & supplies. Medicare Part-B Primary, Plan F AARP Order: Ohtuvayre, Pari Cups & Tubing

Ms. Phillips, It looks like you should be running low. How much of the Ohtuvayre do you have left?

Choose the best reply:

Oh, I have more than enough. But thank you for calling..

Hi, Ms. Philiips. I'm calling because it's time to schedule your breathing medications for Yupelri and Disposable Cups & Tubing prescribed by Dr. Johansen and wanted to confirm that 2484 Whitley Dr is the correct address?

Yes, this is her.

Hello! This is Ann calling from your pharmacy DirectRx. Is this Ms. Lori Phillips I am speaking with?

Ok, you should be ready for a refill. Is your doctor aware of any changes to your treatment plan?

Patient D: Lori Phillips

Alert: 3/01/24: $0 Ohtuvayre & supplies. Medicare Part-B Primary, Plan F AARP Order: Ohtuvayre, Pari Cups & Tubing

Has there been any changes in your treatment plan?

Choose the best reply:

I have over a month left, plenty to go.

Ms. Phillips, It looks like you should be running low. How much of the Ohtuvayre do you have left?

Are you taking your medication as prescribed?

Patient D: Lori Phillips

Alert: 3/01/24: $0 Ohtuvayre & supplies. Medicare Part-B Primary, Plan F AARP Order: Ohtuvayre, Pari Cups & Tubing

It is important to ask open ended questions to find out patient experiences and be sure to listen and not assume!

PATIENT HANGS UP

No, and I am feeling fine. You can just call me back in a month..

Ok, you should be ready for a refill. Is your doctor aware of any changes to your treatment plan?

Try Again!

Patient D: Lori Phillips

Alert: 3/01/24: $0 Ohtuvayre & supplies. Medicare Part-B Primary, Plan F AARP Order: Ohtuvayre, Pari Cups & Tubing

Ms. Phillips it shows you should be running pretty low now. Has there been any changes in your treatment plan?

Choose the best reply:

Yes, I am fine like I said. Just call me next month. Thanks..

Are you taking your medication as prescribed?

Ok, thank you for letting us know we will call back soon.

Patient D: Lori Phillips

Alert: 3/01/24: $0 Ohtuvayre & supplies. Medicare Part-B Primary, Plan F AARP Order: Ohtuvayre, Pari Cups & Tubing

Ms. Phillips it shows you should be running pretty low now. Has there been any changes in your treatment plan?

Choose the best reply:

Yes, I am fine like I said. Just call me next month. Thanks..

Are you taking your medication as prescribed?

Ok, thank you for letting us know we will call back soon.

Patient D: Lori Phillips

Ok, thank you for letting us know we will call back soon.

Choose the best reply:

No changes. I am doing just fine and feeling well.

Ok, you should be ready for a refill. Is your doctor aware of any changes to your treatment plan?

How much do you have left so we know when to call back and check in? It's important to take this regularly.

Alert: 3/01/24: $0 Ohtuvayre & supplies. Medicare Part-B Primary, Plan F AARP Order: Ohtuvayre, Pari Cups & Tubing

Patient D: Lori Phillips

Alert: 3/01/24: $0 Ohtuvayre & supplies. Medicare Part-B Primary, Plan F AARP Order: Ohtuvayre, Pari Cups & Tubing

It is important to ask open ended, probing questions from the beginning to understand a patient's story. Once we find out more about the patient and why they are not ready for a refill, we can address and educate the patient appropriately.

Thank you so much, you guys are awesome!

Ok, thank you for letting us know we will call back soon.

Try Again!

Patient D: Lori Phillips

Alert: 3/01/24: $0 Ohtuvayre & supplies. Medicare Part-B Primary, Plan F AARP Order: Ohtuvayre, Pari Cups & Tubing

It is important to ask open ended, probing questions from the beginning to understand a patient's story. Once we find out more about the patient and why they are not ready for a refill, we can address and educate the patient appropriately.

I have about a month left. Thank you so much!

How much do you have left so we know when to call back and check in? It's important to take this regularly.

Try Again!

Patient D: Lori Phillips

Alert: 3/01/24: $0 Ohtuvayre & supplies. Medicare Part-B Primary, Plan F AARP Order: Ohtuvayre, Pari Cups & Tubing

I am glad to hear you're feeling good! This is a maintenance medication though, so it should be used regularly in order to build up in your system. Ohtuvayre should be taken twice daily.

Ok, thank you for letting us know we will call back soon.

Choose the best reply:

No, I take it when I need it and I have been feeling pretty good.

Has there been any changes in your treatment plan?

Patient D: Lori Phillips

Alert: 3/01/24: $0 Ohtuvayre & supplies. Medicare Part-B Primary, Plan F AARP Order: Ohtuvayre, Pari Cups & Tubing

GREAT JOB!When patients have an excess supply of medication it is important to determine how much they have and how often they are taking that medication because they may be confused on the prescription instructions.

Ah ok, twice? I didn't realize that. I'll make sure to take it as I should from now on..

I am glad to hear you're feeling good! This is a maintenance medication though, so it should be used regularly in order to build up in your system. Ohtuvayre should be taken twice daily.

Patient D: Lori Phillips

That is correct.

Hi, Mr. Manley. I'm calling because it's time to schedule your breathing medications for Albuterol, Formoterol Yupelri and Disposable Cups & Tubing prescribed by Dr. Smith and wanted to confirm that 243 S Donahue Rd is the correct address?

Yes, it is.

Hello! This is Ann calling from your pharmacy DirectRx. Is this Mr. Manley I am speaking with?

Alert: 2/01/24: 09/06/2024 $3.82 Albuterol, $282.27 Yupelri, $173.48 Formoterol, $15 Nebulizer, $0.60 Tubing (D), $0.30 Mask. Humana Med Adv Primary Order: Albuterol, Yupelri, Formoterol, Disposable Cups + Tubing

Patient E: Gerald Manley

I understand.Have you considered applying for funding to help with copay cost?

Choose the best reply:

WOW! That's a lot, I can't believe it's that much! .

Thank you! Do we have permission to use the card on file for the medication copay? The total cost is $459.57

This is the total cost for all the medications and supplies. Just to confirm, is Humana Medicare Advantage your primary insurance?

Alert: 2/01/24: 09/06/2024 $3.82 Albuterol, $282.27 Yupelri, $173.48 Formoterol, $15 Nebulizer, $0.60 Tubing (D), $0.30 Mask. Humana Med Adv Primary Order: Albuterol, Yupelri, Formoterol, Disposable Cups + Tubing

Patient E: Gerald Manley

When patients are concerned about copay costs, it is important to verify their insurance and remind them of their coverage. Also, do not assume they cannot afford the medication until they verbalize this as it is normal to expect some patients will be unhappy with costs even though they plan to pay them!

No problem! We can try in a few weeks again. Have a nice day!

I don't have time right now, maybe next time..

It can help with copay costs. We just need to go through a questionaire to find out some information and find the best option for you.

I am not familiar with that..

I understand.Have you considered applying for funding to help with copay cost?

Try Again!

Alert: 2/01/24: 09/06/2024 $3.82 Albuterol, $282.27 Yupelri, $173.48 Formoterol, $15 Nebulizer, $0.60 Tubing (D), $0.30 Mask. Humana Med Adv Primary Order: Albuterol, Yupelri, Formoterol, Disposable Cups + Tubing

Patient E: Gerald Manley

I understand. Some of these medications are very costly- in fact, before your insurance the Yupelri alone is $1,100 so it looks like your insurance is covering about 80% of that medication.

Choose the best reply:

Yes, I just can't believe how expensive these are..

This is the total cost for all the medications and supplies. Just to confirm, is Humana Medicare Advantage your primary insurance?

Ok, you should be ready for a refill. Is your doctor aware of any changes to your treatment plan?

Alert: 2/01/24: $0, Bud, Arfor Medicare Part-B Primary, Plan F BCBS Order: Yupelri, Budesonide

Patient E: Gerald Manley

GREAT JOB!When patients voice concern over cost, make sure to verify insurance and discover whether they are venting about cost or truly cannot afford it. We can expect patients to dislike the costs but we cannot assume that means they do not have the funds to pay for it.

Ms. Phillips it shws you should be running pretty low now. Has there been any changes in your treatment plan?

Yes, I just can't believe how expensive these are. Go ahead and the charge the card, just wish this was cheaper!

I understand. Some of these medications are very costly- in fact, before your insurance the Yupelri alone is $1,100 so it looks like your insurance is covering about 80% of that medication.

Alert: 2/01/24: $0, Bud, Arfor Medicare Part-B Primary, Plan F BCBS Order: Yupelri, Budesonide

Patient E: Gerald Manley

• Ask probing questions - make sure to ask questions if/when responses don't make sense.
• The use of open-ended questions can often help to get more accurate answers (e.g., when was the last time you changed your cups and tubing?)
• Watch your tone of voice and make sure to align with patients' needs.
• LISTEN.
• Be prepared to repeat questions (sometimes with different wording) or responses to patients' concerns.
• We always need to know how much medication a patient has on hand, and if there is more than 1-2 weeks, we need to know WHY they have more than anticipated.
• We always need to know if a doctor is aware of changes to a treatment plan.

Tips for Handling Patient Hesitancy