Key Takeaways

• Using supportive and empathetic language in prior authorization conversations helps clients feel heard rather than defensive.

• Structuring your script with clarity, reassurance, and step-by-step guidance makes these difficult conversations smoother and more professional.

Why Prior Authorization Conversations Can Turn Defensive

When a client hears that a prescription or service requires prior authorization, the reaction is often frustration. They may view it as a denial or a delay in care. As an independent licensed agent, you play a crucial role in reframing that moment from a negative obstacle into a supportive process. The difference comes down to the words you choose and the structure of your delivery.

Many clients feel blindsided because prior authorization sounds like extra red tape. If you approach the conversation with empathy and structure, you can reduce defensiveness and set expectations clearly.

The Core Principles of Supportive Scripts

To write prior authorization scripts that work, you need to balance compliance with compassion. Here are the principles that matter:

• Clarity over jargon: Avoid technical language your clients may not understand. Use terms they can repeat later when talking to their provider.

• Empathy as the foundation: Acknowledge their frustration before moving into solutions.

• Transparency about next steps: Lay out the process in a timeline so clients know what will happen and when.

• Reassurance about outcomes: Position yourself as their advocate rather than the bearer of bad news.

Structuring Your Script Step by Step

1. Start with acknowledgment

Begin with a sentence that recognizes the client’s perspective. For example: “I understand it can feel frustrating to hear that there’s another step before this prescription or service is approved.”

2. Clarify what prior authorization means

Explain simply that it is a review process where the plan checks if the treatment is covered and medically necessary. Avoid framing it as a denial.

3. Outline the process in plain language

Break it down into clear steps. For example:

• The provider submits a request.

• The plan reviews it.

• A decision is made within a certain timeframe, often a few business days but sometimes longer.

4. Give realistic timelines

Most Medicare-related prior authorization reviews are completed within a set number of days, typically within 14 calendar days for standard requests, or 72 hours for expedited requests if waiting would harm the client’s health. Share these timelines so expectations are realistic.

5. Position yourself as the advocate

Say explicitly that you will help guide them through the process and that you are available to check on updates if needed.

Script Example Framework

Here is a framework you can adapt to your own voice:

• Opening: “I want to walk you through what’s happening so you feel fully informed.”

• Empathy: “I know this feels like one more step, and that can be stressful.”

• Definition: “A prior authorization just means your plan wants to review the request to make sure the service is covered and appropriate.”

• Process: “Here’s what happens: your provider will send in the request, the plan will review it, and they’ll respond within 14 days. If your provider marks it as urgent, it can be as quick as 72 hours.”

• Reassurance: “You are not alone in this. I’m here to help if you want me to follow up or check in on the progress.”

Phrasing That Reduces Defensiveness

The tone you use can either open or close the client’s mind to the process. Choose words that validate their feelings and focus on support.

• Instead of: “Your medication is not approved yet.”
  Try: “Your plan just needs to review this medication before it’s finalized.”

• Instead of: “You’ll have to wait until they decide.”
  Try: “This review usually takes up to 14 days, but I’ll help you keep track of the status.”

• Instead of: “There’s nothing I can do.”
  Try: “Your provider will send in the request, and I can support you by checking on the progress with you.”

Building Confidence Through Repetition

Scripts work best when practiced. Rehearse your lines so they sound natural rather than robotic. This helps you maintain calm and supportive energy, which clients will sense immediately.

Try practicing aloud, focusing on steady pacing and a warm tone. When the words come smoothly, you’ll be able to focus on listening to the client’s emotions rather than worrying about what you’ll say next.

Using Timelines to Set Expectations

One of the most powerful tools you can use is time framing. Medicare outlines specific processing times, and sharing those numbers makes clients feel less left in the dark.

• Standard timeframe: 14 calendar days for a decision.

• Expedited timeframe: 72 hours if waiting could seriously affect health.

By giving exact durations, you prevent clients from imagining an indefinite wait. This alone reduces defensiveness.

The Role of Active Listening

A script is not just about what you say. It is equally about how you respond. Practice pausing after key points to let the client express concerns. Reflect their feelings back with statements such as:

• “It sounds like you’re worried this could delay your treatment.”

• “I hear that you’ve had this experience before, and you want to avoid that stress again.”

This ensures your client knows you’re not just reading from a script but actually paying attention.

Customizing Scripts for Different Situations

Not all prior authorization conversations are the same. Sometimes it is for a medication, other times for a service or medical equipment. While the structure stays the same, the wording may change.

For prescriptions, emphasize how the plan wants to make sure the medication is safe and effective. For services or equipment, highlight how the plan checks whether it’s the right fit for the client’s health needs. Tailoring your words to the context helps the client see the process as reasonable rather than arbitrary.

Turning Scripts Into Client Trust

A defensive client conversation can erode trust quickly. But when you use supportive scripting, the opposite happens: the client feels you are walking alongside them. Over time, these conversations become proof points that strengthen loyalty and encourage renewals.

Clients remember how you made them feel during stressful times. If they felt supported and reassured during the prior authorization process, they are far more likely to stick with you in future enrollment cycles.

Why Supportive Scripts Matter for Renewals

Every renewal season, clients recall the points of friction from the year before. If prior authorization conversations felt adversarial, they may seek another agent. On the other hand, if those conversations felt like coaching and advocacy, they will stay.

This is why scripting is not just about communication in the moment. It is a retention strategy for your book of business.

Putting It All Together for Professional Growth

The skill of writing supportive prior authorization scripts is not just about handling tough conversations. It’s about establishing your role as a trusted advocate, someone who brings clarity, empathy, and confidence to clients navigating Medicare.

Scripts are tools, but the real value is in how you use them. With empathy, clear timelines, and consistent reassurance, you transform prior authorization from a defensive moment into a teaching moment.

Building Long-Term Client Trust Through Empathy

Your words have lasting impact. By refining your scripts today, you prepare yourself for smoother conversations tomorrow. As an independent licensed agent, every supportive conversation you deliver adds to your reputation for professionalism and care.

If you want to strengthen your ability to deliver these conversations and gain access to resources that make your job easier, we invite you to sign up with BedrockMD. Our tools and support are designed to help professionals like you have these conversations with confidence and efficiency.