Aetna/Coventry...dejavu All Over Again

Nov 16, 2015

  1. SKJ58
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    Noticed today that my entire book with Aetna is terminating 01/01. Called broker support, talked to 2 people. Both said that HMO is terminating for my counties in Florida. Not so, I said. Only 1 county is terminating, the other counties have same CMS number next year. They offered to forward me to member services. Said they were not trained to deal with this issue.
     
    Last edited: Nov 17, 2015
    SKJ58, Nov 16, 2015
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  2. FLM2
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    I went through the same thing-my Lee County book showed terminated before AEP so I rewrote almost all of them the first couple of weeks.

    Then I look at my Sarasota county book on Monday and it shows as 'Terminated', I email my rep and he says 'No, they aren't'.

    I call Agent Services and they say 'Yes, letters were sent out in September'.

    I call my rep and he says 'No' and sends an email to someone internally about that a couple of days ago, since then I've heard nothing.

    I then had one of my clients look at their ANOC in Sarasota and there is no cancellation notice, just a statement about the plan name being changed. That makes it clear to me that there in no plan termination in Sarasota (Hillsborough is OK also).

    It's just amazing how stupid some of these CSRs are, just incredible.
     
    FLM2, Nov 19, 2015
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  3. G.Gordon
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    Contract numbers changed here locally. Wife freaked out seeing tons of member with 12/31 terminations. I told her don't sweat it, they changed digits, they have to term that number and reissue the new digit. No biggie.
     
    G.Gordon, Nov 19, 2015
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  4. Iwillpay
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    They not stupid, they just don't know, they are not trained. if an agent call member services they cant handle agent questions.
     
    Iwillpay, Nov 20, 2015
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  5. FLM2
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    That's no excuse, the CSR at Agent Services immediately said the plan was terminated without even hesitating. It's intentional, as far as I am concerned.

    I don't call Member Services because agents have no standing with them and they won't answer questions.

    No one protects an agent other than him/herself, it's ridiculous to write business for a company and not be respected enough to get an accurate answer.

    In this case Aetna is the loser, I've moved more than half my book to another company.
     
    FLM2, Nov 20, 2015
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  6. Iwillpay
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    I know what you are talking about, just called one today and ask for commission dept, " I am sorry that is not on my list"
    Well I owe I owe so off to work I go.
     
    Iwillpay, Nov 20, 2015
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  7. BuckNasty
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    Every time I hear stories like this it re-enforces my decision to stay focused on Med Supps. Sick of companies treating agents like they are red headed step children.
     
  8. FLM2
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    Aetna did it again today, sent an email informing us that everything for Aetna HMO plans in Florida needs to be done through the Coventry site, including doctor searches, and that the use of Aetna provider numbers 'could delay' enrollments.

    Does Aetna actually know that AEP started over a month ago and there are only two weeks left?

    Here is the email, read it and weep if you haven't received it:

    Florida Medicare agents: Review upcoming changes for you and Aetna Medicare HMO members, as well as need-to-know info for the rest of AEP


    We want to let you know about some upcoming changes for you and your Medicare clients.


    1. Remember, Coventry Health Care and First Health Part D are part of the Aetna family

    Aetna purchased Coventry and First Health Part D in 2013. As we continue to come together as one company, members will hear and see the Aetna or Coventry names and logos on a more regular basis.


    For example, Florida Coventry MA/MAPD members and First Health Part D members may hear, “thank you for calling Coventry, an Aetna company” when they call us. They may also see the Aetna name or logo on their materials.


    In addition, as a result of some system integration efforts, Florida Aetna Medicare HMO members may actually see the Coventry name and logo on some of their materials. This is a result of system integration efforts. Please see below for some of the changes Aetna Medicare HMO members can expect.


    As we keep working on becoming one company, our members will continue to be at the center of everything we do. If you ever have questions or concerns, just reach out to your local Aetna/Coventry Medicare broker manager.



    2. For Florida Aetna Medicare HMO enrollments, search for providers through the Coventry Provider Lookup tool, NOT through Aetna Medicare DocFind

    As a result of system integration efforts, before submitting applications for Florida Aetna HMO plans, you need to use the Coventry Provider Lookup tool to find a Primary Care Provider (PCP), and then include the corresponding PCP number on the application. Just go to Coventry Medicare: Home and click “Locate a Provider” at the top.

    Please do NOT use Aetna Medicare DocFind for Florida Aetna HMO members. Using the PCP number from DocFind on Aetna HMO applications will cause processing delays and possible incorrect PCP assignment.



    3. Make sure you include BOTH your National Producer Number (NPN) and Coventry Agent Writing Number (AWN) on Florida applications


    When completing paper enrollment forms for Aetna and Coventry MA/MAPD and PDP products in Florida, remember to include both your AWN and your NPN in the Agent Information section. This will allow us to process your enrollments as quickly as possible. If you forget to include both numbers, it will cause processing delays. It will also take longer for the enrollments to appear in your application-status reports. Use our 2016 Enrollment Instructions Flyer as a guide.


    4. When submitting applications by fax, make sure you use the correct fax number

    MA/MAPD plan type Location Fax number
    For Aetna and Coventry FL HMO applications South/North FL 877-573-0074
    For Aetna and Coventry FL HMO applications Central FL 866-669-5604
    For Aetna FL PPO applications Statewide 888-665-6296

    Sending applications to the wrong fax number will delay processing. For guidance on submitting enrollments, check out our 2016 Enrollment Instructions Flyer.



    5. Here’s what’s changing for Florida Aetna Medicare HMO members

    All Florida Aetna Medicare HMO members will receive a new member ID card with a new toll-free number for Member Services. The new ID cards should arrive in the mail in mid-December. Please encourage your Aetna Medicare HMO clients to call the new Member Services number shown on their new ID card if they have any questions about their plan.

    There’s a new online member portal for Florida Aetna Medicare HMO members too. The new portal for these members is the My Online Services site. Members can use it to check claim history, look up in-network providers and much more. Aetna HMO members in Florida can login to this website starting January 1, 2016, by visiting https://member.cvty.com.


    Please note: These changes apply to Aetna Medicare HMO members in Florida only. There’s no impact for Aetna Medicare PPO members. Aetna Medicare PPO members should continue to use the Member Services number on their existing member ID card and their existing member portal website (either Aetna Navigator or My Online Services).


    6. Aetna HMO members will be part of your Coventry commission statement starting in January

    Starting in January, your Coventry Medicare commission statement will include Aetna Medicare HMO members. You can view a sample of the commission statement format here. Your Aetna Medicare PPO commission statement will remain the same.


    Questions? Contact your local Aetna/Coventry Medicare broker manager

    Region Name Business phone and email
    Jacksonville/South FL Arlexi Gray (813) 663-3700, [email protected]
    Tampa Juanita Ransom (352) 812-9479, [email protected]
    Tampa/Southwest FL Mark Iannello (727) 736-1653, [email protected]
    South Florida Naomi Crabtree (954) 375-1552, [email protected]
    Jacksonville/South FL Paul Montemayor (786) 344-3777,
    [email protected]
     
    FLM2, Nov 24, 2015
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  9. MedicareAgent
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    My customers are now calling because they got auto assigned a doctor, yep, I used the aetna doc find site.
    So, I called and asked to look up my customers apps and they can only look up 5 at a time and i have to then dial back in. Yikes !!
     
  10. SKJ58
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    Notice in the email that Aetna commissions will be paid by Coventry in 2016. Why do I have the feeling that I won't see any commissions until March or April?
     
    SKJ58, Nov 24, 2015
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