CMS Compliance

[retread]

That happens quite a bit. I had a situation earlier this year on a preset appointment for Wellcare for a medicare/medicaid person. When I got to the appointment, the lady wouldn't open the door, just kept hollering at me, "what do you want" thru the door. I finally got her crack open the door and told her that I was to see her at 2:00. She said she knew nothing about it. I told her the appointment was just set 24 hours ago. She still didn't remember, but, invited me in. When I sat down at the kitchen table, there was a Wellcare brochure and app sitting there. I asked her what that was for and she didn't know. I asked her if I could look at it and she gave me permission. It was a completed app for Wellcare Duet that she had enrolled in the day before. I asked her about and she had no clue about what she had done. I asked her about getting on the phone with Wellcare and completing the app with the agent present. She said she remembered a "little" about doing that. She would have enrolled again with me that day if I had not seen the other app.

I'm sure that when they did the verification call, the lady could not complete it. Is the agent the one to blame there? She may have been more lucid the day before when he was there. She certainly had to complete the enrollment call as this was in May and Wellcare had mandated only teleapps and there was a confirmation number on the app he left there.

Who knows? The lady may have scheduled an appointment with another agent after me as well.

That lady is exhibiting signs of dementia, and as an ethical agent, I would not begin to make a sales presentation. I would try to find a relative that would be the responsible party and make sure they know what is going on. I would then attempt to make an appointment with all parties present.

In your case, if it were me (and I have had similar experiences), I would jot down the agent's name off the material left behind, and keep it for future reference.

 

[jdeasy]

That lady is exhibiting signs of dementia, and as an ethical agent, I would not begin to make a sales presentation. I would try to find a relative that would be the responsible party and make sure they know what is going on. I would then attempt to make an appointment with all parties present.

In your case, if it were me (and I have had similar experiences), I would jot down the agent's name off the material left behind, and keep it for future reference.

I did.

 

[retread]

On the hallowed walls of the US Air Force Academy are hung signs that remind cadets of the honor code:

"I will not lie, cheat, or steal,
or tolerate among us those who do."

Line 1 most people will agree is honorable, but line 2 is where the rubber meets the road. If we don't insist that everyone cooperates in this endeavor, then the criminals will rule.

 

[Frank Stastny]

The only sensible solution is to ignore this bullshit.

Rick

Amen!

I chuckle at all the posts where agents are trying to guess what can and can't be done and still be in compliance with CMS.

We are all only guessing, some are making their "guess" sound more logical than others but at the very best it is still only a guess.

That wasn't meant to be a slam against anyone or their best guesses. The problem is that no one really knows, or if there is someone who does none of us know who that person is.

If any agents are really concerned about being in 100% compliance, both of you haha, should contact CMS and get an answer in writing specifically stating that it is either okay or not okay to use the interpretation asked about.

There will be agents who feel secure in their interpretation and will think they are in compliance but won't be. They will never get checked on by CMS. Then there are others who will also think they have found a loop hole only to get their ass nailed to the wall by CMS.

Since no one really knows how far CMS will go in checking on agents the whole thing is a crap shoot. It is obvious that CMS cannot check on everyone.

It wouldn't surprise me if CMS required the carrier to also send out a questioneer with every policy asking the client to fill it out and return it. The questions would be to make sure the original contact and the presentation were 100% as CMS has stated they should be.

The bottom line is that if an agents wants to deviate from the word by word interpretation handed down by CMS, that agent is putting his/her ass on the line regardless of what we all think and/or may say or post here.

 

[midwestbroker]

CMS compliance all depends on what day you have met with your client.

Today all you need is a reply card. Tomorrow who knows.

 

[Insuranceman]

Who knows what CMS will nail you for and what the penalty will be. Last year I got rebremanded by CMS . I received a letter informing me that I had 14 days to recertify thru my carrier or I could no longer be eligible to sale MA plans. I complied and never heard anything more about it but I was never given a reason or feed back on what I did wrong.