CMS Violation or Not?

[fostever]

CMS has installed wires on all beneficiaries and cameras in their homes that snap a picture of you when you violate so be careful.

 

[Cenla Agent]

If you want a laugh call the MA carrier and then call MEDICARE and see what different answers you get ... that should be a good post.

And then call the carrier and Medicare twice more after that (and maybe your FMO or manager as well, if applicable) and see how many more answers you can get.

 

[Russ]

CMS has installed wires on all beneficiaries and cameras in their homes that snap a picture of you when you violate so be careful.

If that's the case, then I'm probably in trouble.

 

[stormtracker]

Suffice it to say that outside the house an agent is obedient. Once inside the house, the agent is compliant. With signed contract, the agent is twice-removed from either. Without, he is obliged to neither.

 

[retread]

Suffice it to say that outside the house an agent is obedient. Once inside the house, the agent is compliant. With signed contract, the agent is twice-removed from either. Without, he is obliged to neither.

Is this a quote from Confucius?

 

[MedSuppPro]

Is this a quote from Confucius?

Nah, Stormtracker was comparing an MA agent to a dog. Pavlov referred to this learned relationship as a conditional reflex (Conditioned Response). CMS calls it SCOPE. Agents refer to this as mouthwash.

​

 

[retread]

I tell you what I WOULD LIKE TO VIOLATE CMS AND MY PROVIDER! They have screwed over so many of my customers so bad it is unbelievable. I have people with no coverage that were enroled in the first part of the AEP and I have told them about it multiple times for the same people and they still have no coverage! (each time they say nothing wrong with the application just and internal problem we will take care of it) CMS and these rules are a JOKE the problem is with cms and internal with providers.

I hope you dated the application as received by agent & signed and dated. If you did, they are covered. All they need to do is present their copy.

 

[MedSuppPro]

Jim,

Help us out! What is a "Provider"? This sounds like a Carrier problem. Many of us are on the edge of our seat...

Can you name names? My experience is garbage in, garbage out, and CMS is the decider no the divider of garbage in.

So, if the carrier is whom we think it is, we may not be surprised. Then again nothing surprises anymore...

 

[stormtracker]

Can you name names? My experience is garbage in, garbage out, and CMS is the decider no the divider of garbage in.

"Garbage in, garbage out..." Couldn't have said it better myself.

 

[retread]

I know they are covered but they are not getting put in the system they gave me numbers for the pharmacy to call and they still will not give them drugs I guess because they are not in the system. (pharmacies do not have to fill drugs based off an application and a lot do not) This gives people the choose to either pay the whole bill and get reenbursed latter or no drugs if they can not afford it. ( I told them some people do not have the money to pay for all of it and they said nothing else we can do) Called again today same damn answers we will take care of it. BS And further more I have been locked out of the ap tracker for days when I called they said they could not fix it and we will have someone call you in 72 hours. Some reason I doubt I get a call.

You might get some response if you mentioned if they heard what happened to Wellpoint earlier this month....