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Emily Rodriguez

PSP Case Manager

Interaction INT-003 · Mar 6, 2026

Overall Score

75/100

Score Overview

Rubric Breakdown

Opening & Rapport

4/5

Observation

Warm and friendly opening that made the patient feel comfortable. Quickly established the purpose of the call.

Suggestion

Should verify patient identity before discussing any case details, even in a warm opening.

Evidence

[00:00]“Hello, Margaret. This is Emily Rodriguez from the Neurexil Patient Support Progr...”

Patient Support Navigation

5/5

Observation

Exceptional navigation of complex insurance barriers. Identified three distinct pathways to ensure the patient could access medication.

Suggestion

Continue this comprehensive approach. Consider creating a written action plan for the patient summarizing all options.

Evidence

[02:10]“There are a few paths we can explore. First, Dr. Peters can submit a medical exc...”

Needs Assessment

3/5

Observation

Understood the patient's immediate need but did not explore broader concerns or caregiving situation.

Suggestion

Ask about the patient's overall experience with MS management, not just the immediate prescription issue.

Evidence

[00:48]“We tried Neurexil because the interferon injections were causing terrible flu-li...”

Compliance & Regulatory

2/5

Observation

Significant gap in HIPAA compliance. Discussed PHI and collected PII with a third party present without obtaining documented verbal consent.

Suggestion

Always verify authorized representatives before sharing any patient information. Obtain and document verbal consent when a third party is present.

Evidence

[00:25]“Hi Karen, nice to meet you. Margaret, let me pull up your case file.”

Closing & Next Steps

3/5

Observation

Established follow-up actions but did not provide a clear timeline for the appeal process or set expectations.

Suggestion

Summarize all action items with specific timelines and provide a written follow-up communication to the patient.

Evidence

[04:00]“I'll also send a letter of medical necessity template to Dr. Peters' office to s...”

Empathy & Communication

4/5

Observation

Showed genuine care for the patient's situation and reassured her about treatment continuity.

Suggestion

Acknowledge the emotional burden of dealing with insurance barriers in addition to managing a chronic condition.

Evidence

[03:25]“We definitely don't want any gaps in your treatment.”

Documentation Quality

3/5

Observation

Collected necessary information for bridge enrollment but did not explicitly document the HIPAA consent gap or third-party presence.

Suggestion

Document all parties present on calls and their authorization status. Log consent verification steps in the case notes.

Evidence

[03:45]“Sure, it's April 15, 1958, and the last four are 7824.”

Coaching Focus Areas

HIPAA Compliance Procedures

Critical gap in third-party consent verification. Must verify and document authorization before discussing any PHI with non-patients present.

Target: Pause at the start of every call to verify identity and obtain explicit verbal consent when third parties are present, documenting it in the case file.

Identity Verification Sequence

Patient identity should be verified before any case details are discussed, not partway through the conversation.

Target: Complete identity verification within the first 30 seconds of every patient call, before accessing or discussing any case information.

Timeline Communication

Patients need clear expectations about process timelines for insurance appeals and program enrollment.

Target: Provide specific day-count estimates for each step in the access process and send a written summary to the patient.