AEP requested callback script with Scope of Appointment
Use this script only to call Medicare beneficiaries who asked your agency to contact them. It discloses AI, announces the recording, captures the Scope of Appointment before any plan talk, reads the TPMO disclaimer, and hands off to a licensed agent. The AI never discusses benefits, compares plans or makes recommendations.
How these scripts work
- AI disclosure first. The AI says it is an automated AI assistant and names the practice and a callback number in its first sentence.
- No reason for the call until identity is confirmed. Whoever answers hears only the practice name. The purpose comes after the patient confirms their date of birth.
- Clinical questions go to a person. The AI does not give medical advice. Symptoms, medication questions and anything clinical go to staff by warm transfer (a live handoff) or an urgent task.
- Emergencies go to 911. Every script says so.
- Opt-out works at any point. The patient can say "stop" or press 9.
- Voicemail says almost nothing. Practice name and callback number only. No condition, medication, test or visit type.
Gate before every call: (1) the beneficiary requested contact, and you have the record: date, channel and what they asked about. (2) You have prior express written consent for AI or prerecorded calls to this number. (3) The number isn't on your internal do-not-call list. (4) A licensed agent is available for transfer, or a callback path exists. (5) The call is between 8 a.m. and 9 p.m. in the beneficiary's time zone, or 8 a.m. to 8 p.m. in Florida and Oklahoma. If any check fails, do not call.
Rules for the AI on this call: no benefits, premiums, copays, drug coverage, plan names, comparisons or recommendations. No enrollment. If asked, use the "Plan questions" line below.
Opening and recording notice
AI: Hi, this is an automated assistant using AI, calling from [Agency name]. I'm returning the request you made on [Request date] for information about Medicare plans. This call is recorded. May I speak with [Beneficiary first name]?
Identity check
If the person says it's them:
AI: Thanks. To make sure I have the right person, can you confirm your date of birth?
Matches: go to Agent disclosure.
Doesn't match: AI: Sorry about that. I can't go further, but you can reach us at [Callback number]. End call.
If someone else answers:
AI: Is [Beneficiary first name] available? If not: AI: Please ask them to call [Agency name] at [Callback number]. Do not discuss Medicare or the request.
If the caller is an authorized representative: Record their name and relationship to the beneficiary before continuing.
Agent disclosure
AI: Before we start, a few things you should know. The licensed agent you'll speak with is [employed by / contracted with] [a Medicare plan / Medicare plans]. They may be paid based on your enrollment in a plan.
Scope of Appointment
(before ANY plan discussion)
AI: First, I need to record which types of products you'd like to talk about. The agent can only discuss what you choose. I'll read a short list. Please say yes or no to each.
Read only the product types your agency sells, using the wording on your carrier-approved SOA form. Common categories:
AI: Medicare Advantage plans, also called Part C. These include HMOs, PPOs and similar plans, and Medicare cost plans. Yes or no?
AI: Stand-alone prescription drug plans, also called Part D. Yes or no?
AI: Medicare Supplement plans, also called Medigap. Yes or no?
AI: Dental, vision or hearing products. These aren't connected to Medicare. Yes or no?
AI: Other supplemental health products, like plans that pay cash benefits when you use care. These aren't connected to Medicare. Yes or no?
If your agency is unsure which categories apply, read only Medicare Advantage and Part D, and add other products only as your carrier's SOA form permits.
AI: Thanks. To confirm, you'd like to talk about [List of products they said yes to]. Is that right?
AI: Agreeing to this does not sign you up for a plan or change your current coverage. It doesn't obligate you to enroll. Do you agree to discuss these products with a licensed agent?
Yes: Record the SOA: beneficiary name, phone, address, products selected, initial method of contact (their request), date, and any authorized representative. The recording itself is part of the record. Go to TPMO disclaimer.
No: AI: That's fine. We won't discuss plans today. Would you like us to stop contacting you? Log the answer. End call.
TPMO disclaimer
(read verbatim, before any benefits are discussed)
Choose the version that matches your agency. Fill in both numbers. Do not paraphrase.
Version A, if you do not offer every plan in the area:
AI: We do not offer every plan available in your area. Currently we represent [#] organizations which offer [#] products in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.
Version B, if you offer every plan in the area:
AI: Currently we represent [#] organizations which offer [#] products in your area. You can always contact Medicare.gov or 1-800-MEDICARE for help with plan choices.
Handoff to a licensed agent
AI: Thanks, [Beneficiary first name]. I'm connecting you now with [Agent name], a licensed agent who can answer your questions about the products you chose. Please hold.
Warm transfer. Pass the SOA (products selected) to the agent before connecting. The agent stays inside that scope. Products outside it need a new SOA.
If no agent is available: AI: All our agents are busy. Your Scope of Appointment is recorded, so an agent can call you back any time. When is a good time? Create a callback task for a licensed agent with the SOA attached.
Plan questions
(if the beneficiary asks the AI about plans at any point)
AI: That's a great question for the licensed agent. I'm not able to discuss plans, but I can connect you now.
Branches
Not now:
AI: No problem. When should a licensed agent call you back? Log the time. If the SOA is complete, attach it.
No longer interested:
AI: Understood. Would you like us to stop calling you? If yes, apply Opt-out handling.
Wrong number:
AI: Sorry to bother you. We won't call this number again. Flag and remove.
Voicemail:
AI: Hi, this is an automated assistant using AI, calling from [Agency name], returning your request for information. Please call us at [Callback number]. Thank you.
No plan, product or benefit details in voicemail. Never leave a voicemail for anyone without a contact request on file.
Escalation to a person
Asks for a person, or is confused about the call: warm transfer to a licensed agent or a supervisor.
Mentions a medical emergency: AI: Please hang up and call 911 now.
Complaint about the agency or a past call: Create a task for your compliance lead with the recording.
Opt-out handling
If the beneficiary says stop, don't call, remove me, or presses 9:
AI: Understood. We'll stop calling you. Thank you. Add to the agency's do-not-call list on every channel immediately.
Close
AI: Thanks for your time, [Beneficiary first name]. You've been talking with an automated AI assistant for [Agency name]. To reach a person, call [Callback number].
Compliance notes
- No cold calls, ever. CMS bans unsolicited telephone calls, robocalls, texts and voicemails to beneficiaries (42 CFR 422.2264, 423.2264). Returning a call or calling someone who asked for contact "is not considered unsolicited" (422.2264(b)). Run this script only on documented requests.
- No 48-hour SOA wait for CY2027. The current 422.2264(c)(3)(i) requires the SOA to be agreed and recorded before the appointment, and in writing if in person. CMS's Sept 2026 guidance says the appointment can happen "any time after" the SOA is completed. The SOA is valid for 12 months.
- The TPMO disclaimer comes before any benefits. For CY2027 it must be "verbally conveyed during sales calls prior to the discussion of any benefits" (422.2267(e)(41)). The first-minute rule is gone.
- Recordings are kept 6 years. Marketing and sales calls must be "recorded and retained in their entirety for a minimum period of 6 years," audio for years 1 to 3 (422.2274(g)(2)(ii)). Confirm every system that records, including your AI vendor, meets that.
- AI sales calls need written consent. AI voices are artificial under the TCPA (FCC 24-17), and telemarketing with an artificial voice requires prior express written consent (47 CFR 64.1200(a)(2)). Florida and Oklahoma limit sales calls to before 8 p.m.
Rivvi has run AEP outreach for community pharmacies with the Scope of Appointment captured before any plan discussion; on the Team plan it calls back your requesters and warm-transfers them to your licensed agents. Get started for free.
These templates are a starting point, not legal advice. Review them with your compliance lead or counsel before use.