Scripts for Insurance Calls That Actually Get Approvals

Fibromyalgia doesn’t just demand energy for managing pain, fatigue, and flares—it demands energy for something even less forgiving: insurance companies.

If you’ve ever called about a claim, prior authorization, or coverage question, you know the drill. Long hold times. Repeated transfers. Conflicting answers. And the crushing reality that if you don’t phrase things the “right” way, you may walk away without the coverage you actually qualify for.

After years of battling denials and wasting spoons on endless calls, I finally realized I needed to approach insurance conversations like performances. Not manipulative, but strategic: using scripts, specific phrases, and structured questions that push the process toward approval.

Here’s how I built scripts that consistently improved outcomes, reduced denials, and saved my energy—plus templates you can adapt for your own insurance battles.

Why Scripts Matter

Insurance reps aren’t just listening to your story—they’re listening for keywords that match policies and procedures. If you ramble, they may dismiss your request. If you use the wrong terms, they may log it inaccurately.

Scripts help by:

Keeping your energy focused.
Making sure you hit the right language.
Building a paper trail with consistent wording.
Preventing brain fog from derailing the call.

Scripts turn a stressful, draining call into something structured and predictable.

Step One: Preparation

Before picking up the phone, I prepare three things:

My policy info (ID number, group number, coverage type).
Doctor’s supporting notes if available (diagnosis codes, letters of medical necessity).
A script template ready to guide the call.

Even a sticky note with three key sentences makes a huge difference when fatigue and fog hit mid-conversation.

Step Two: The Core Script Structure

Every insurance call follows the same skeleton. My script templates fit into this flow:

Introduction: Who you are, your policy info.
Purpose: The exact request or issue.
Verification: Repeating back what the rep confirms.
Escalation: Requesting a supervisor or case manager if needed.
Documentation: Asking for reference numbers and written confirmation.

Step Three: Sample Scripts

Here are the scripts I use most often, word-for-word.

Script 1: Prior Authorization Request

“Hello, my name is [Name], and I’m calling about my coverage. My ID number is [____]. I need to confirm the prior authorization process for [treatment/device/medication] for my diagnosed condition, fibromyalgia, ICD code [M79.7].

Can you please tell me exactly what documentation is required for approval, and where my provider should send it?”

Key phrases that work:

“ICD code [M79.7]” → shows you know medical coding.
“Exactly what documentation is required” → prevents vague answers.

Script 2: Denial Appeal (First Call)

“I received a denial notice for [treatment/device/medication]. I’d like to file an appeal. Can you confirm the exact appeal process, the address or portal where it should be submitted, and the timeline for review?

Also, please note in my file that I am requesting this appeal today.”

Key phrases that work:

“File an appeal” (not “argue” or “disagree”).
“Please note in my file” → creates a paper trail.

Script 3: Escalation to Case Manager

“I need to speak with a case manager or supervisor regarding my ongoing condition. Because fibromyalgia is a chronic illness with flare cycles, I need consistent handling rather than repeating my story each time. Can you transfer me to someone who can manage my case directly?”

Key phrases that work:

“Chronic illness with flare cycles” → frames the need for ongoing support.
“Consistent handling” → avoids fragmented records.

Script 4: Requesting Coverage Clarification

“Before I schedule this treatment, I need to confirm whether it is a covered benefit under my plan. The treatment is [name], used for [reason]. Can you check whether it requires prior authorization, and if so, what the approval criteria are?”

Key phrases that work:

“Covered benefit under my plan” → uses their own language.
“Approval criteria” → forces specific answers.

Script 5: Medication Exception Request

“My doctor has prescribed [medication], but I was told it requires step therapy. Because of my fibromyalgia diagnosis and history of side effects with other medications, I need to request a medical exception. Can you explain the process for submitting this request?”

Key phrases that work:

“Step therapy” → acknowledges the rule.
“Medical exception” → the phrase that triggers the right department.

Step Four: The Follow-Up Formula

Every call ends with three key asks:

“Can you give me the reference number for this call?”
“Can you spell your name and give me your extension, if available?”
“Will I receive written confirmation of what we discussed?”

This turns fleeting words into documentation you can use in appeals.

Step Five: Spoon-Saving Tactics

Because these calls are exhausting, I use extra strategies:

Set a timer: No call over 30 minutes without a break.
Speakerphone + notepad: Keeps my hands free from strain.
Template notes: I fill in blanks rather than writing from scratch.
Call in the morning: Fewer transfers, less hold time.
Tag in support: When possible, I let a caregiver or advocate use my scripts.

Real-World Results

Before scripts, I lost half my battles with insurance. After scripts:

Prior authorizations approved faster.
Appeals taken seriously.
Fewer contradictory answers.
Less brain fog panic mid-call.

Scripts didn’t make insurance easy, but they shifted the power dynamic: I sounded prepared, I got better responses, and I spent fewer spoons repeating myself.

Downsides + Lessons Learned

Not foolproof: Some reps still give wrong info. Documentation matters more than tone.
Energy drain: Even with scripts, calls eat energy. I now schedule recovery time afterward.
Persistence required: Approvals usually take multiple calls.

Lesson: scripts save spoons, but persistence wins the fight.

FAQs

1. Do scripts really improve insurance approvals?
Yes—using the right terms and structures reduces denials and speeds up processing.

2. What’s the most important phrase to use?
“Please note in my file.” It creates a legal trail.

3. How do you handle brain fog on calls?
Use written scripts. Even reading line by line keeps you on track.

4. Should I record calls?
Only if legally allowed. At minimum, always get a reference number.

5. Can caregivers use scripts on my behalf?
Yes, with authorization on file. Scripts help them advocate consistently.

6. How do I stay calm with difficult reps?
Stick to the script. Don’t debate—redirect to policy language.

Final Thoughts

Insurance battles are some of the hardest parts of chronic illness—not because of the body, but because of the bureaucracy. Scripts won’t erase the frustration, but they turn the process into something manageable. With the right words, the right questions, and a consistent paper trail, approvals become more likely and denials less devastating.

Fibro already steals enough spoons. Don’t let insurance take the rest. Scripts are one way to keep the fight structured, efficient, and survivable.