Health Sherpa

[TxOnline]

TXOnline: If they are submitting their own apps and they are current clients these must be reenrolls? What about them canceling their current plans if they chose a new one? How are you handling that with them? What if they choose a crap plan where you know their Doc doesnt work with the plan but they blindly chose it anyway cuz its cheaper? What then? Not trying to dog you, trying to understand your methods.

Most of my business is existing clients.
I'm doing ALL of the research for them or with them using the HealthSherpa platform.
I'll ensure that old plan is cancelled (AFTER new policy IS in their hands).

NONE of them WILL make a bad decision (about coverage or network).
I've done that research FOR them in many cases.
The rest (the easier ones) do that research WITH me over-the-phone.
We're BOTH looking at the HealthSherpa screen together (over the phone).
I direct them to the right spots.
Then, I say:
Just click "Enroll" & fill out your app.
And, call me if you get stuck.


______________
Note:
I spend 30 minutes to 3 hours doing research for my clients!
There is NO way I'll let them pick a plan that doesn't include their must-have doctors/hospitals, etc.
They totally understand HMO's (if that's the right plan for THEM) before they fill out the app!
Etc, etc, etc.

I've already spent 30 minutes (to an hour) on the phone with these clients (before picking out the right plan/choices for/with them).

This IS taking me HOURS per client (on average)!
But, HealthSherpa is SAVING me at least an hour (with their FAST, simple, EASY app)!
Doing a HC.gov app takes me (or them) forever (with conversation going on WHILE we fill in the blanks).

I'm working day & night. The research (and talking on the phone answering questions/explaining) is taking a lot of time. But, that's MY mode-of-operation. I can't just throw my clients to the wolves. Never have. Never will.

...

 

[Bob_The_Insurance_Guy]

Finally figured it out. Someone tell me where I'm wrong, or how I can do it better.

1)Tell the client, if they haven't done so already, to go to healthcare dot gov website, and create an account.

2)In the interim, I/we call their physician's office and ask, "What health insurance companies are you going to be working with ON THE EXCHANGE for 2015?"

3)Then go to Health Sherpa, put in their information. Print out/Open up the Eligibility Letter, to get their HC Confirmation number, so they can see, and cross reference, their plan they've enrolled in.

Step 3 can be done using the link I send them. Just need to show them where they can find the confirmation number.

As someone posted previously, I work diligently with them to ensure their doctors are either in or not, and that they have an idea of what to expect.

It may sound cumbersome, but since all these steps can be done with me in person, they can also be done independently as well. My clients prefer - and I do as well - that we work in the same room. They on their laptop. Me on mine.

For my clients that are further away, it can be done independently.

OK. Rip me apart. Let me know how far off the reservation I am.

 

[CHUMPS FROM OXFORD]

Nothing wrong with that. You can also just email your link to client and let them enroll. That's one thing Sherpa will do well. This assumes you have discussed with client their options and the specific plan they will enroll in.

 

[STIBROKER]

apps from the Sherpa showing up at the carriers now... yippe fing do do ....

mannnnn......you are right .....just have the 3 sherpa submitted and are now showing in Recent Activations...........

 

[Evan]

I still have one client done on Monday where no action is occuring. Tried to enroll another lady in Orange County, FL but United wasn't listed. Come up Sherpa I'm trying to give you money.

Edit.. Sherpa expedited my case and rates are now showing. Keep it up Sherpa.

 

[Post Quartermaster]

2)In the interim, I/we call their physician's office and ask, "What health insurance companies are you going to be working with ON THE EXCHANGE for 2015?"



OK. Rip me apart. Let me know how far off the reservation I am.

Way off. Asking a physicians office about network participation is a setup for failure. Carriers provide online provider directories that you can search. Jane Doe at the front desk of the doctors office doesnt know that United or Humana has 5 different networks. Not to mention the fact that they are BUSY, as are we. Use the tools provided by the carriers.

 

[Bob_The_Insurance_Guy]

Way off. Asking a physicians office about network participation is a setup for failure. Carriers provide online provider directories that you can search. Jane Doe at the front desk of the doctors office doesnt know that United or Humana has 5 different networks. Not to mention the fact that they are BUSY, as are we. Use the tools provided by the carriers.

It's actually the billing department I speak to when I make the call.

 

[TxOnline]

I had several nightmares after last Open Enrollment season.

Clients called their doctor's office to ensure that they were IN their new network (only to discover at claim time that they were NOT in their NEW network)!

Several of my Provider Finder tools (on the insurance companies' websites) were indicating that Dr Smith was IN the 2014 network. But, at claim time, the EOB indicated that treatment was performed at an out-of-network provider.

I spent many hours getting these situations straight.

Bottom line:
You cannot trust that the doctors office KNOWS which network(s) they are IN.
You can't even trust that the Provider Finder Search function is accurate.

All you can do is use the insurance company's Provider Finder tools....and pray that they are accurate. They SHOULD be!

I was tempted to SAVE the results (that I found on Provider Finder searches) in the future (after wasting SO much time over claims problems last spring). But, saving those results to my computers proved to be an overwhelming task in itself.

 

[MedicareAgent]

when i look up dr.s i print them out and stick em in the customers folder so i can show at the time you purchased it they were in the online directory.

 

[YouGotMyMoney]

It's actually the billing department I speak to when I make the call.

your wasting your time. do you still want to be pitching and running meetings when your 80?