Industry
Health Insurance
Health Insurance
Telecalling Script

"I'm concerned about out-of-network coverage"

This is a common and valid concern, especially if the prospect wants flexibility in choosing healthcare providers. The key here is to alleviate their fears while highlighting the plan's benefits and addressing any misunderstandings about "out-of-network" limitations.

Underlying Concern:

  • The prospect might fear that they’ll face high out-of-pocket costs or limited access to preferred doctors and hospitals that are not within the insurance provider’s network.
  • They may also worry that out-of-network care will lead to complicated claims processes or coverage denials.

How to Tackle This Objection:

To handle this, you’ll need to:

  1. Clarify the scope of your network and whether their most important healthcare providers are in it.
  2. Reassure them by explaining any out-of-network benefits the plan might include.
  3. Highlight the flexibility of your plan (if applicable), including emergency coverage or the option to negotiate with out-of-network providers.
  4. Offer examples or real scenarios where out-of-network coverage was successfully handled, especially if you have customer testimonials or positive stories to share.

Sample Response:

Prospect: "I'm concerned about out-of-network coverage."

You: "I completely understand your concern, and it’s a great question. Many of our customers initially had the same worry, but we have some solutions that could work well for you."

  • "First, let’s check if your preferred doctors or hospitals are already part of our network. We have a large and expanding network, so it’s very likely that your key providers are covered."

  • "Even if your provider is out-of-network, our plan still offers options for those situations. For example, in emergencies, you’re covered regardless of whether you’re in-network or out-of-network. We also have out-of-network benefits that cover a significant portion of the cost depending on the service, and you can always negotiate rates with providers."

  • "In fact, many of our customers have found that our out-of-network benefits still offer comprehensive protection—it’s just about knowing how to make the most of your coverage. Our customer service team is always available to help you with that."

Prospect: "But what if I need regular treatment from a specialist who's out-of-network?"

You: "Great point. If you have a specific specialist in mind, we can look into whether they are part of our extended network, or we can work with you to find a comparable provider within the network. But even if they remain out-of-network, our plan can still cover a portion of those costs. You also have the option to submit claims and get reimbursed for services outside the network. We’ll walk you through the process to ensure it's as smooth as possible."

Probing Questions to Reassure and Personalize:

  • "Can I ask who your current doctor or specialist is? I can check if they’re part of our network."
  • "Do you typically need out-of-network care, or is this more of a ‘just in case’ concern for you?"
  • "What’s most important to you in terms of coverage—more flexibility with providers, or lower out-of-pocket costs overall?"

Call to Action:

Close by offering to provide detailed information about network coverage or out-of-network options that directly address the prospect's specific concerns.

Example:
"How about this: I can send you a list of the top hospitals and specialists in your area that are in our network, so you can see how comprehensive the coverage is. At the same time, we can explore how we handle out-of-network claims, so you feel fully informed before making any decisions. Does that sound good?"


Key Points to Emphasize:

  • Network Size and Flexibility: Highlight how large or well-connected your provider network is.
  • Emergency Situations: Assure them they are covered in emergencies, even out-of-network.
  • Out-of-Network Benefits: Point out if there are partial reimbursements, claims processes, or negotiation options for out-of-network care.
  • Customer Support: Emphasize that your team is available to help them navigate both in-network and out-of-network claims, so they won’t have to handle it alone.

This strategy aims to reduce the prospect's fear of being stuck without coverage, while showing that your insurance plan offers both protection and support, even when out-of-network services are necessary.

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