Face to Face NOT required for Today's Options
- Thread starter sman
- Start date
- 15,319
You must have missed my post stating the same thing last week.
Nice to know it's been confirmed by multiple people.
Rick
- 1,704
Here we go again. I'm happy to hear this because I want to do some over the phone enrollments, and the h.o. is doing that night and day.
Keep that email.....in case we need backup.
Keep that email.....in case we need backup.
- Thread starter
- #4
Yep. I missed it. I don't get to read everything on the forum.
This is what is stated in the Pyramid training compliance manual..
Outbound Telemarketing:
Outbound telemarketing must be for health related products (e.g., discounts on eyeglasses or health club memberships).
Outbound telemarketing may not be for non-health related items
(e.g., discounts on restaurants, entertainment, or travel) unless the Medicare beneficiary provides prior written authorization.
(e.g., discounts on restaurants, entertainment, or travel) unless the Medicare beneficiary provides prior written authorization.
Must comply with the National, State and Company -Do-Not Call Registries.
Must honor “do not call again” requests.
Must abide by Federal and State calling hours.
Must not enroll Medicare beneficiaries over the phone.
I would not take what someone said as being correct. I talked to someone at Pyramid yesterday that said that there was no way one of my clients could have been taken off their plan until Jan 1 after they switched in November. This member is one I enrolled on Care Improvement and already was showing up on the Medicare.gov website as being on CIP. If someone from Medicare emailed you that statement then if it was wrong that may qualify, but doubt you can get an email from them anyway.
Personally I would not enroll someone over the phone but that's just me. Just because someone set you an email is not going to be an excuse if it is something that violates CMS rules of conduct.
Just my 2 cents.........
- 15,319
CMS does not require face to face enrollments (according to Pyramid's brokerage manager.)Must not enroll Medicare beneficiaries over the phone.
However, I don't think we're enrolling over the phone. Enrollments are done by either on-line enrollment (not available at the moment), or by a wet signature on the application which is mailed back to the agent.
Humana did the telephone enrollments for the past few years but Pyramid never did. The actual enrollment is now subject to at least 2 phone calls verifying.
I will be happy to continue to enroll clients without seeing them. I can make the presentation over the phone and receive a copy of the signed application and other forms by fax, email or snail mail. There is no doubt in my mind that unless the carrier requires a face to face that I will be in compliance with CMS. At least until they change their minds.
Rick
- 1,704
From the horses' mouth:
MEDICARE ADVANTAGE SALES AND MARKETING OVERSIGHT
scroll down to the bottom....and go up 5-6 lines where it says accepts enrollment form in person.
MEDICARE ADVANTAGE SALES AND MARKETING OVERSIGHT
scroll down to the bottom....and go up 5-6 lines where it says accepts enrollment form in person.
- 2,370
According to Humana, the client must have received a CMS approved, full disclosure presentation prior to a phone enrollment by an agent.
Now, how strict they are on that, I cannot say, but that is their rule to cover their own rear.
Now, how strict they are on that, I cannot say, but that is their rule to cover their own rear.
- 15,319
It does not say you must receive this in person. It only states "Employees, brokers and independent agents must first ask for a beneficiary's permission before providing assistance in the beneficiary's residence, prior to conducting any sales presentations or accepting an enrollment form in person."
I believe this is restating that we must have an appointment set in advance before going to see a beneficiary, not that we must see them in person in order to get the enrollment form or make a presentation.
That's my story and I'm sticking to it.
Rick
- 1,704
More required reading.
MARKETING OF MEDICARE ADVANTAGE PLANS, ABBY L. BLOCK, DIRECTOR, CENTER FOR BENEFICIARY CHOICES
This mentions a new CMS MA report card.....and market conduct reported to state DOI's
MARKETING OF MEDICARE ADVANTAGE PLANS, ABBY L. BLOCK, DIRECTOR, CENTER FOR BENEFICIARY CHOICES
This mentions a new CMS MA report card.....and market conduct reported to state DOI's
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