sop-compliance-checklist

name	sop-compliance-checklist
description	Standard operating procedure compliance checklist for evaluating pharmaceutical patient support call handling against required procedural steps

SOP Compliance Checklist

Overview

This checklist defines the required procedural steps for handling patient support calls. Use it to evaluate whether the agent followed all required steps during the call.

When to Use

Use this checklist when reviewing agent performance on any patient support call. Score each item as Completed, Partially Completed, or Not Completed.

Required Checklist Items

1. Call Opening & Identity Verification

• Agent identified themselves by name and department
• Agent asked for patient's full name
• Agent verified patient identity using at least two identifiers (DOB, member ID, phone number)
• Agent confirmed the enrolled program and medication before proceeding

2. Active Listening & Issue Documentation

• Agent acknowledged the patient's reason for calling
• Agent used reflective listening to confirm understanding of symptoms or concerns
• Agent asked clarifying follow-up questions when needed
• Agent documented key details accurately during the call

3. Adverse Event Handling

• Agent recognized potential adverse event language from the patient
• Agent gathered required AE information: symptom description, onset, severity, frequency
• Agent asked about concomitant medications
• Agent informed the patient that an adverse event report would be filed
• Agent explained the AE reporting process in patient-friendly language
• Agent recommended the patient contact their prescribing physician

4. Enrollment & Program Management

• Agent correctly accessed and referenced patient enrollment records
• Agent explained available options clearly (e.g., shipment hold, resumption)
• Agent processed requested changes accurately
• Agent confirmed the action taken and next steps with the patient

5. Billing & Copay Assistance

• Agent verified copay coverage details against enrollment records
• Agent identified and escalated billing discrepancies appropriately
• Agent provided a clear timeline for resolution
• Agent confirmed the patient understood the resolution process

6. Call Closing

• Agent summarized key actions taken during the call
• Agent reminded patient of important follow-up actions (e.g., contacting physician)
• Agent offered to assist with additional questions
• Agent closed the call professionally

Scoring Guidelines

Rating	Criteria
Excellent (90-100%)	All checklist items completed, empathetic tone throughout
Satisfactory (70-89%)	Most items completed, minor gaps in documentation or process
Needs Improvement (50-69%)	Several items missed, procedural gaps that could affect patient safety
Unsatisfactory (<50%)	Critical items missed, potential compliance violations