fishfortwo
Expert
- 96
I have a couple that have been on a local carrier for their MAPD for a couple of years. Someone got in the door and wrote them in a National carrier for AEP. A different agent saw them on December 13th. and said they should be in the plan that I had them in and used an SEP-Disaster to write them in that plan. Their plan never terminated. The local carrier said that because they made a choice to change plans in AEP that I was no longer the AOR.
I know the Green Mafia would still have me as AOR if they were in that carrier's plan and this happened. I know SEPs have priority, but the plan never terminated that they were on. I think this is happening because the local carrier is not too sharp on CMS rules, as we have had issues in the past with these types of situations.
I just wanted to get the forums input on this to see if I am missing something and they are correct or not.
I know the Green Mafia would still have me as AOR if they were in that carrier's plan and this happened. I know SEPs have priority, but the plan never terminated that they were on. I think this is happening because the local carrier is not too sharp on CMS rules, as we have had issues in the past with these types of situations.
I just wanted to get the forums input on this to see if I am missing something and they are correct or not.