The goal of this article is to describe how our system saves patient consent after they're enrolled in one of our CareSignal programs.
What is a waiver?
A waiver is how the CareSignal system records consent. A waiver is stored for each program that a patient enrolls into. For example, if a patient enrolls into our Diabetes and Asthma programs, they will have a waiver for Diabetes and a separate waiver for Asthma.
A waiver is either confirmed or revoked. There are a variety of ways that a waiver gets its confirmed status. A waiver is marked as revoked if a patient opts out of a CareSignal program (either by pressing * during a phone call, or by texting in STOP to the program number). Since waivers are stored per program, a patient would need to opt out of both programs to stop getting messages from CareSignal altogether.
New waiver records are created when a new patient prescription is created, even for a program that they had in the past. For example, if a patient's Diabetes program ends due to having an end date set in their prescription, if that patient is enrolled into Diabetes again, a new waiver record will be created.
How does a waiver get confirmed?
A waiver can be set to confirmed a variety of ways. In this section, we will describe the most typical flow when a patient enrolls via our Engagement Specialist team or via an account's Self-Enrollment Portal.
To describe the flow, we will use a fictitious patient named Jill who is brand new to the CareSignal platform. It's Tuesday, and Jill has just completed her enrollment call with one of our Engagement Specialists.
She has agreed to enroll in both programs she is eligible for: Asthma & Diabetes. For both programs, she wants to receive phone calls at 10AM CST. For Asthma, she wants her phone calls to come on Wednesdays, and for Diabetes, on Fridays. Since she didn't specify a late start date, her start date for both programs will be set for tomorrow (Wednesday).
Immediately upon enrollment, our system creates a waiver record for both programs and sets the waiver to be confirmed. Though we confirm the waiver automatically, we still value sending out the waiver messages so that (1) we can confirm the phone number associated with the patient actually belongs to that patient and (2) so that the patient has the opportunity to save the program phone number to their phone prior to their first program question outreach. Since Jill specified phone calls for her program messages, the system will schedule 3 phone calls for each program. The schedule is:
- Phone call 1 will go out 1 day prior to the program start.
- Phone call 2 will go out 1 day after the first waiver call.
- Phone call 3 will go out 3 days after second waiver call.
If Jill answers the first phone call and answers all of the prompts, the second and third phone calls will be canceled. Given Jill's prescription preferences, here are the phone calls that Jill might receive:
- Asthma
- Call 1 on Tuesday
- Call 2 on Wednesday
- Call 3 on Saturday
- Diabetes
- Call 1 on Tuesday
- Call 2 on Wednesday
- Call 3 on Saturday
Waiver message content
When Jill gets the waiver phone call, this is what she'll hear:
| "Hi, this is a service of {provider contact display name}. We have a confidential message for Jill. Press 1 if you are Jill. Press 2 if you want to go get Jill. Press 3 if you are not Jill. |
Prior to the above message playing, if the account has created a Program Introduction for that CareSignal program, it will play. To view, edit, or create new Program Introductions, visit the "Program Introductions" section of your Account Configuration page.
If Jill presses 3, she will have the option to either opt out of this program, or start the call again.
If Jill presses 2, she will be prompted to go find the patient. Once she finds the patient and returns with them, pressing any key will continue the flow.
If Jill doesn't answer, the system will assume it is a voicemail and will play:
| If you are receiving this message in a voicemail, please call us back at {program phone number}. Once again that is, {program phone number}. |
If Jill presses "1", since Jill's waiver is already confirmed, the system will not ask for her explicit consent again. Instead she'll either hear the following generic message, or if the program has a custom waiver message, that will play instead.
| You are now enrolled in communications by {provider contact display name} to help provide better care. You may press star at the beginning of each call to unsubscribe. Have a good day! |
Our Asthma program doesn't have a program-specific waiver message, so Jill will hear the above message for that call. Our Diabetes program, however, does have one, so for that waiver call, Jill will hear:
| We will be asking you questions about your blood sugar to help your doctor take care of you. Please save this number as your care team. You will soon receive reminders to check and tell us your blood sugar. Standard call rates may apply. You can press star at the beginning of any call to unsubscribe. Please call your provider if you feel overly thirsty, pee frequently, feel sick to your stomach, vomit, have blurry vision, feel confused or have any health questions. |
To summarize:
- Jill will receive at least two waiver calls on the day she enrolls (since her start date is next day). One call will be for our Asthma program and the other for our Diabetes program.
- If Jill answers the call and confirms her identify (by pressing "1" for the phone call version), the additional waiver calls will be cancelled.
- Though not described above, waiver text messages work in almost exactly the same way as waiver calls.
Confirm name call flow
Though this doesn't directly concern waivers, the messaging is similar, so we decided to include this section here as well. At the start of each program phone call that Jill receives (note: this flow does not occur for program text messages), she will hear the following:
| Hi, this is a service of {provider contact display name}. We have a confidential message for Jill. Press 1 if you are Jill. Press 2 if you want to go get Jill. Press 3 if you are not Jill. If you would like to stop communications, you may press star to unsubscribe. If you are receiving this message in a voicemail, please call us back at {program phone number}. Once again that is, {program phone number}. Once again, this is a service of {provider contact display name}. |
Prior to the above message playing, if the account has created a Welcome Recording for that CareSignal program, it will play. To view, edit, or create new Welcome Recording, visit the "Welcome Recordings" section of your Account Configuration page.
If Jill presses 3, she will have the option to either opt out of this program, or start the call again.
If Jill presses 2, she will be prompted to go find the patient. Once she finds the patient and returns with them, pressing any key will continue the flow.
If Jill presses 1, the program messages will start.
Provider contact display name
Various messages in this article have made reference to the {provider contact display name}. As a reminder, each program a patient is enrolled into is associated with a provider contact. These provider contacts can be viewed, created, edited, or deleted on the "Provider Directory" page, "Manage Contacts" tab.
In the table that loads there, the Display Name is what will replace the {provider contact display name} in the program messages. If you're looking at a provider contact's information, this is also found in the Patient-Facing Name field.