For FMO Partners

Your agents get the
best leads
in Medicare.

Patient Coverage Connect delivers clinically sourced, pre-qualified Medicare referrals directly into your agent network — complete with the patient's medications, diagnoses, current plan, and the specific coverage question that triggered the referral. The highest-quality lead channel in the market. All you have to do is let them in.

What your agents receive
A complete clinical brief — delivered before they make a single call.

Referrals route automatically to certified agents through their existing CRM. No lead queue to manage. No accept button. The agent signs up, sets availability, and referrals arrive — matched to their book of record where the FMO platform supports it.

→ Patient name, contact, current plan, and the specific coverage question that triggered the referral
→ Active medications, diagnoses, and income indicators from the clinical record
→ Patient permission documented with timestamp — compliant from the start
→ Patient is expecting contact — the provider arranged it
The $0 follow-up model

Once an agent has paid for a patient's first lead, every future referral for that patient routes back to them at no charge — for as long as their relationship remains active. Every patient in their book becomes a free, fully briefed annual re-engagement.

67M+
Medicare beneficiaries touched by clinical settings regularly — each with coverage data already on file
$0
Currently captured from the provider referral channel — entirely analog until now
30 sec
Time for clinical staff to submit a fully briefed referral — no data entry, no IT integration required
$0
Cost for every follow-up referral for a patient already in an agent's active book of record
How It Works

The referral your agents
have always wanted.

A Medicare advisor receives a referral that includes the patient's name, contact information, current plan, medications, relevant diagnoses, and the specific coverage question that triggered the referral — where available in the patient's clinical record. Before they make a single call. The patient has given permission, documented with a timestamp.

1

Coverage gap identified

In PCC Direct, staff identifies a coverage question and submits a referral — simple, 30 seconds. In PCC Integrated, the platform detects gaps automatically: formulary changes, low-performing plans, SNP-qualifying diagnoses, T-65 events, plan terminations — before the appointment, before the patient knows.

2

Patient gives permission. Referral is built.

The patient gives permission, documented with a timestamp. In PCC Integrated, the clinical record is parsed automatically. In PCC Direct, staff attaches a standard clinical summary download. Either way, the referral is fully briefed — medications, diagnoses, current plan, coverage question — before the agent makes contact.

3

Referral routes to the right agent

The platform checks for an existing agent relationship. If one is found and the agent is enrolled in the lead program, the referral routes to them automatically. If not, it routes to the next available agent in the campaign. Every patient's first referral carries the full lead fee regardless of routing path.

4

Agent arrives knowing. Patient gets helped.

No cold calling. No discovery. No wasted appointments. The agent already knows the patient's situation before making contact. The advisor relationship begins from a position of expertise and trust — established by the provider who arranged it.

What makes this different from every other lead source

Internet leads are bought, recycled, and cold. Patient Coverage Connect leads come from inside a clinical encounter — the highest-trust setting in healthcare.

The patient has already identified a coverage need in front of a provider they trust, with permission documented. Your agent arrives not as a salesperson but as a solution the provider arranged.

  • Permission documented with timestamp — compliant from the start
  • Clinical brief eliminates discovery — agent goes straight to solutions
  • Medications, diagnoses, current plan, and income indicators where available in the clinical record
  • Advisor relationship starts with clinical credibility
  • Covers physician offices and pharmacies
  • All Medicare product types — MA, PDP, supplement, social programs that seed future leads
Lead Quality

The lead source that was always there.
Now captured.

Premium pricing reflects clinical sourcing, pre-qualification, and conversion advantage no other channel can match. These are not the cheapest leads. They are the best ones.

Internet / Digital Leads

Standard market lead
❌

Generated by consumer search or advertising — often recycled across multiple agents

❌

No clinical context — agent arrives without knowing the patient's situation

❌

Consent implicit — not documented at a trusted clinical moment

❌

Cold contact — patient may not remember requesting information

Lowest conversion

Patient Coverage Connect

Clinical referral — highest quality
✓

Sourced inside a clinical encounter — physician or pharmacist

✓

Clinical brief — medications, diagnoses, current plan, coverage question where available in the record

✓

Permission documented with timestamp at point of care

✓

Patient is expecting contact — the provider arranged it

✓

All Medicare product types — no referral type restrictions

Highest conversion

Direct Mail / TV Leads

Traditional lead generation
❌

Mass market — not pre-qualified for specific coverage needs

❌

No clinical context — discovery conversation required

❌

Response lag — patient interest may have passed

❌

High volume, low specificity — difficult to prioritize

Average conversion
Pricing Model

Every first referral. Full price.
Every follow-up. No charge.

Patient Coverage Connect uses a first-contact premium model with a $0 ongoing relationship fee — giving agents a powerful incentive to build their book through the platform and use it as their compliance and communication layer for every patient interaction.

First Contact — Every Patient

Every patient's first referral through Patient Coverage Connect carries a premium lead fee — regardless of any prior agent relationship. The AOR check identifies the patient's existing advisor and asks whether they're enrolled in the lead program with availability set. If yes, routes to them at full price. If not, routes to the next available advisor.

FMOs may co-op or sponsor lead costs as an agent retention and recruitment tool.

Premium Per lead — same price for all first contacts

Ongoing — Same Patient

Once an agent has received and paid for a patient's first lead, all future referrals for that patient route back to them at no charge — for as long as the AOR relationship remains active and uninterrupted in their CRM. The referral routes to the active agent of record at the moment of referral, as identified by the CRM.

Agents can tell their book of record to hit Request Review in their patient portal each year. Every client who does sends the agent their latest clinical information as a free, fully briefed lead — an entire book re-engaged annually at no cost.

$0 All subsequent leads while AOR is active and uninterrupted
What the patient sees
Your advisor — one tap to re-engage
9:41
●●● WiFi 🔋
‹ Insurance Summary Close
← Back to Insurance Summary
Coverage Overview
Humana Gold Plus H1036 / Medicare Advantage HMO
✓ Information from Humana. Prices may vary.
Robert T. Hollis
H10360041882
⚠️
Formulary change. Eliquis moved to Tier 4. Now $180/fill vs. $8. Annual cost increase ~$2,064. No therapeutic equivalent.
💊Prescription Drug Coverage (Part D)
Levothyroxine 200mcg
Thyroid · 30-day supply
$8/fill
Tier 1
Apixaban (Eliquis) 5mg
Blood thinner · AFib
$180/fill
Tier 4 ↑
Allopurinol 300mg
Gout · 30-day supply
$8/fill
Tier 1
ℹ️
You may qualify for Extra Help with prescription costs. Ask your advisor.
Your Medicare Advisor
Jenny Woods
Jenny Woods
Rural Health Advisors
👨‍⚕️ Your Care Team Coverage
The patient sees their advisor's name and a Request Review button directly in their coverage portal — one tap re-engages the relationship at no cost to the agent
For Your Agents

Minor certification. Major leads.

Agents access Patient Coverage Connect referrals through a brief online certification, developed in conjunction with the Rural Health Association's Medicare Education program and based on 15 years of working directly with providers. This is a quality standard that protects the integrity of the clinical referral channel and the providers who use it. Providers need to know their patients are being connected to advisors who meet a standard.

What agents need to participate

  • Active Medicare license in good standing
  • FMO affiliation with a participating platform partner
  • Brief online certification — covering clinical referral workflow, patient communication standards, and coverage navigation basics
  • Enrollment in the lead program with availability set in their CRM — the system routes only to agents who have confirmed they can accept leads
  • That's it. No lengthy credentialing. No in-person requirement.

What agents receive

  • Access to the highest-quality lead channel in Medicare distribution
  • Complete clinical brief with every referral — medications, diagnoses, current plan, income indicators where available in the clinical record
  • Referrals sourced from physician offices and pharmacies
  • All Medicare product types — MA, PDP, supplement, Extra Help, social programs that seed future leads
  • AOR recognition through their existing CRM — referrals route back to them for patients already in their active book
  • $0 ongoing leads for every patient in their active book — pay once for the first referral, no charge for follow-ups while AOR is active and uninterrupted
  • Annual free re-engagement of their entire book via the patient portal Request Review button
Agent certification & registration →
The Field Force

Built on relationships
that took a decade to build.

Over a decade of relationships with rural health associations and agency operations across four states gives PCC credibility with provider communities that no technology company can purchase.

Rural Health Associations nationally have expressed willingness to promote PCC to their members once the platform is released. Provider onboarding is simple and self-service — a provider is live in under an hour. Agents who do not maintain professional standards in clinical settings are removed from the platform, giving providers a meaningful assurance about who their patients are being connected to.

The provider trust problem is what has kept this channel analog for decades. PCC is built specifically to solve it.

National
National footprint — activating with provider onboarding as clinical partners come online
20 min
Provider staff orientation — BAA, workflow training. Done.
All
Clinical settings — physician offices, pharmacies, community health centers
Referrals per provider — every Medicare patient encounter is a potential referral event
FMO Onboarding

Three steps. Then your agents
start receiving referrals.

1

Platform integration

We connect to your agent management platform to enable lead delivery and agent identification. The minimum requirement is the ability to return an agent name and contact for the 1:1 consent match. AOR lookup is supported where your platform enables it. Our team handles the technical integration.

2

Agent certification

You notify your agent network about the Patient Coverage Connect clinical referral channel. Agents complete the brief online certification and set their availability in the CRM. Live within days — no in-person requirement.

3

Referrals start flowing

As providers come online, referrals begin routing through your platform. Every provider onboarded generates a continuous source of pre-qualified leads — and every patient in an agent's active book becomes a $0 follow-up lead for as long as the AOR relationship is active and uninterrupted.