Deceased- Charge-backs

[fostever]

I've been doing MAPD for 13 years and should know this, but I need confirmation. Back in the early days before MIPPA you had no commission charge backs after 3 months. Now it's a pro-rated charge-back depending when they sep drop during the year. (I personally prefer as earned, but anyhoo they say that's not available) I was under the impression that a deceased client was not counted as a charge-back, since I knew of clients that died and I received no charge-back or I missed it, not sure. Anyway, is there a MIPPA CMS rule on that or does it depend on the carrier? Thanks in advance.

 

[Chazm]

If they disenroll within 3 months it's a rapid disenrollment and you get fully charged back. If it's after that 3 months then you get charged back the prorated amount. Should be the same for everyone.

 

[fostever]

If they disenroll within 3 months it's a rapid disenrollment and you get fully charged back. If it's after that 3 months then you get charged back the prorated amount. Should be the same for everyone.

Including the dearly departed I'm assuming, I knew the other part.

 

[Chazm]

If they're dead, they're not enrolled so

 

[TwoCents]

From the CMS Marketing guidelines:

Rapid disenrollment compensation recovery does not apply when CMS determines that recoupment is not in the best interests of the Medicare program. Such situations include when a beneficiary disenrolls within the first three months for any of the following reasons:

Death (among a list of other reasons)

 

[VolAgent]

If they're dead, they're not enrolled so

Speak for yourself. They make great clients, never file a claim or complaint. And since it is $0 premium, never have to worry about a check bouncing.

 

[vic120]

Speak for yourself. They make great clients, never file a claim or complaint. And since it is $0 premium, never have to worry about a check bouncing.

They do however Vote

 

[VolAgent]

They do however Vote

It is the least I can do for them. Particularly considering they are such great clients.

 

[fostever]

From the CMS Marketing guidelines:

Rapid disenrollment compensation recovery does not apply when CMS determines that recoupment is not in the best interests of the Medicare program. Such situations include when a beneficiary disenrolls within the first three months for any of the following reasons:

Death (among a list of other reasons)

Maybe I worded the question wrong, but I wasn't talking about rapid DE's, it was about pro-rated chargebacks from a client that dropped after 3 months. With MAPD you get a lump sum in January for renewals and AEP sales then if they SEP out during the year the company takes part of that commission back (carry a negative balance until the following January) depending on how close to the end of the year they drop. Anyhoo, I believe from the answers that yes deceased are counted in that negative balance.

 

[wehotex]

I've been doing MAPD for 13 years and should know this, but I need confirmation. Back in the early days before MIPPA you had no commission charge backs after 3 months. Now it's a pro-rated charge-back depending when they sep drop during the year. (I personally prefer as earned, but anyhoo they say that's not available) I was under the impression that a deceased client was not counted as a charge-back, since I knew of clients that died and I received no charge-back or I missed it, not sure. Anyway, is there a MIPPA CMS rule on that or does it depend on the carrier? Thanks in advance.

Of all ppl that I enrolled that died within the first 3 months, it happened to be my Dad. Aetna paid me for the 1 month when he was alive (January) and charged back the rest of the year. If they did after the 4th month, then pro-rated chargeback I assume.