October 5, 2020 Office Meeting Notes under the video. To see more of our office meetings, click here. See the video: <!@split@> {“@context”: “http://schema.org”,”@type”: “VideoObject”,”name”: “Officemeetingfinal1″,”description”: “This video contains Officemeetingfinal1″,”thumbnailUrl”: “https://embed.vidello.com/71/z2vymqat14br50tf/video/splash.jpg”,”uploadDate”: “2020-10-05T20:31:27.000Z”,”duration”: “PT36M28S”} Included in this meeting: Medicare…
The internet is abuzz with promotion after promotion toward agents.
Everyone calls themselves an expert these days with the goal of recruiting more agents to follow them like the pied piper.
𝗪𝗵𝗮𝘁 𝗶𝘀 𝗿𝗲𝗮𝗹?
𝙒𝙝𝙖𝙩 𝙞𝙨 𝙟𝙪𝙨𝙩 𝙖 𝙛𝙖𝙘𝙖𝙙𝙚 𝙩𝙤 𝙡𝙪𝙧𝙚 𝙣𝙚𝙬 𝙖𝙜𝙚𝙣𝙩𝙨, 𝙟𝙪𝙨𝙩 𝙡𝙞𝙠𝙚 𝙩𝙝𝙚 𝙈𝙇𝙈 𝙁𝙞𝙣𝙖𝙡 𝙀𝙭𝙥𝙚𝙣𝙨𝙚 𝙖𝙜𝙚𝙣𝙘𝙞𝙚𝙨 𝙙𝙤?
𝐒𝐨𝐦𝐞 𝐐𝐮𝐞𝐬𝐭𝐢𝐨𝐧𝐬 𝐭𝐨 𝐀𝐬𝐤 𝐘𝐨𝐮𝐫 𝐍𝐞𝐰 𝐎𝐧𝐥𝐢𝐧𝐞 𝐈𝐧𝐬𝐮𝐫𝐚𝐧𝐜𝐞 𝐖𝐢𝐳𝐚𝐫𝐝:
✔ How did YOU exactly start in the insurance business?
✔ What experience do you have in growing an agency?
✔ Is it possible to duplicate your agency's success today?
✔ What are your core values in dealing with customers as it relates to profits?
Updates from this week that we spent in Washington, DC and what to expect in Medicare for this AEP and beyond.. {“@context”: “http://schema.org”,”@type”: “VideoObject”,”name”: “DCTrip1″,”description”: “This video contains DCTrip1″,”thumbnailUrl”: “https://embed.vidello.com/71/uushnj3wj97ibahk/video/splash.jpg”,”uploadDate”: “2019-08-29T12:01:16.000Z”,”duration”: 1574.29} NAHU is working on several legislative initiatives….
This is a pretty good webinar from Humana on the opportunities beyond AEP for the Medicare Advantage space. Video: {“@context”: “http://schema.org”,”@type”: “VideoObject”,”name”: “Humana How to Navigate OEP and New SEP Opportunities”,”description”: “This video contains Humana How to Navigate OEP and…
In the first quarter of the year, starting in 2019, seniors will be able to make ONE change in or out of MAPD or PDP into another one, if they wish. This expands the “disenrollment period”, which has been in existence…
by Leslie Small | FierceHealthcare
Medicare Advantage organizations (MAOs) continue to do a poor job of maintaining accurate provider directories—and it’s landing some in hot water with the federal government.
In its second round of online provider directory reviews, the Centers for Medicare & Medicaid Services found that 52% of the provider directory locations listed had at least one inaccuracy.
Those errors included providers who weren’t at the location listed, providers who didn’t accept the plan at that location, providers who weren’t accepting new patients despite the directory saying that they were, and incorrect or disconnected phone numbers.
When CMS conducted its first review of MAOs’ provider directories, it found that 45% of locations listed were inaccurate. While the report does say that the first and second reviews aren’t directly comparable “due to minor updates to the review methodology,” at the very least, the latest review’s results indicate the problem isn’t getting any better.
CMS also noted that its findings were not skewed by a few organizations but instead were widespread in the sample reviewed, which was about one-third of all MAOs. “Very few organizations performed well in our review,” the agency said.
At a minimum, provider directory errors can make members frustrated with an MAO, the report noted. But they can also cast doubt on the adequacy and validity of the MAO’s network as a whole, and even more seriously, prevent members from accessing services that are critical to their health and well-being.
RELATED: Study takes stock of MA hospital networks
Based on the results of its reviews, CMS has sent 23 notices of noncompliance, 19 warning letters and 12 warning letters “with a request for a business plan” to Medicare Advantage insurers.
However, the agency emphasized that MAOs themselves “are in the best position to ensure the accuracy of their plan provider directories.” It also said it was encouraged by pilot programs aimed at developing a centralized repository for provider data that would be accessible to multiple stakeholders.
In the near term, CMS added, MAOs should perform their own audits of their directory data and develop better internal processes for members to report errors.
See the original article here:
https://www.fiercehealthcare.com/cms-chip/medicare-advantage-provider-directory-errors-network-adequacy
If so, in addition to the AHIP test, there is now another, separate test administered only through CMS and it is required.
This test is on Waste, Fraud, and Abuse, as there always had been in the AHIP test already, but now it's required separately.
Courtesy of United Healthcare, this is a link to the instructions as to how to find and take this simple test:
Now See their video: My Notes, with the timestamp I'm referring to: 4:32 You can offer any of our Med Supps Guaranteed Issue (if they're cancelled off of their MAPD plan). This is true of any company, by the way….
A bipartisan group of senators, as well as the very powerful AHIP group lobbied the administration to not cut funding. With the mid-term elections coming quickly, the administration listened and has decided to put off the cuts to Medicare Advantage….
Medico's New: Hospital Indemnity Plan. This new plan is more competitive, easier to sell, and through their electronic application, easy to enroll. You can contract with Medico now for a pending state and they will begin processing of your contract….
Glad we are focused on Medicare Supplements, which remain untouched by this news. - CW
Health insurers participating in the Medicare Advantage program for elderly Americans, including Humana Inc. and UnitedHealth Group Inc., face a payment cut of about 3.55 percent next year, the U.S. government said.
CEOs' trepidation
“There's a lot of trepidation awaiting this letter and not a few Wall Street analysts and CEOs who are like a long-tailed cat in a room full of rocking chairs these days,” John Gorman, executive chairman of Gorman Health Group, a consulting firm in Washington, said before the cuts were announced. “There's all kinds of things around that could hurt.”
Consumers who choose Advantage plans are opting for managed care, with benefits including lower out-of-pocket costs, over the traditional government-run Medicare program for the elderly and disabled. Government payments have been under pressure since 2010, when the U.S. health expansion was financed in part by reducing spending on Advantage plans by an estimated $206 billion over a decade.
At the time, U.S. spending for Advantage beneficiaries was estimated to be as much as 13 percent higher than for people enrolled in traditional Medicare, leading to criticism the Advantage plans were overpaid.
Even after the cuts, the Medicare Payment Advisory Commission, which studies the program for Congress and recommends cost savings, estimates that Advantage plans were paid about 4 percent more in 2013, per beneficiary, than the cost of the traditional program.
‘Seniors are watching'
Last year, the administration raised 2014 base payments for Advantage insurers by 3.3 percent, after initially proposing a 2.2 percent reduction.
Still, insurers say that other government decisions — including a new tax on the industry under the Patient Protection and Affordable Care Act and budget sequestration ordered by Congress — reduced their Advantage payments about 6.7 percent in total this year.
Before Friday's announcement, insurers predicted a proposed cut of as much as 6.5 percent. Their lobbying campaign has included posters plastered around Washington that picture an elderly man with a pair of binoculars, with the warning “Seniors Are Watching.”
Senators' letter
The 40 U.S. senators who wrote to Medicare administrator Marilyn Tavenner to ask for payments to be frozen were led by Charles Schumer, D-N.Y., and Michael Crapo, R-Idaho.
The program “has been a great success and should remain a competitive choice for our constituents,” the senators said. “We urge you to maintain payment levels that will allow MA beneficiaries to be protected from disruptive changes in 2015.”
While Medicare actuaries estimate enrollment in Advantage plans will dip next year, the Congressional Budget Office predicted that participation may rise as much as 50 percent in the next decade to 21 million by fiscal 2023.
Webinar Replay from December 13, 2013 – Year-Round Opportunities This is a year-round business… see the video: Click the image to start the video: > Topics Covered: Cross selling opportunities NOW: First, see this webinar on cross selling final expense…
See the video: <!@split@> (NOTE, As of 2019, this period is now called the MAPD OEP – and there is now the option (January 1 to March 31) to change Medicare Advantage plans OR leave Medicare Advantage and return…