AgentGeneral
Guru
- 392
I'll chime in
Although I can't speak to SC, I can speak to MI
I'm also in my 3rd full AEP. Technically my 4th, but I didn't do much in 1st considering i was just getting contracted and wasnt even fully invested in it yet.
I thought this would be the best AEP ever. Yes, it is busy AF, and I'm writing non stop most days.
Heres how it's going with Humana and Aetna:
Prior to beginning of AEP, the major hospital network in my area is no longer in network for Aetna. Ok, so switch the client and move on.
Then a few days ago, now Humana is no longer in network.
Luckily I moved my Aetna clients to BCBSM.
But what happened to a colleague was she moved her Aetna people to Humana...and you can guess what happened there. Not fun.
It seems quite volatile this AEP. And I just shake my head when the FMO calls about "building and not moving people" or when they offer large amounts of coop money....yah, right....too busy working with currents.
And then I'm told, well the hospital network will bill out of network, then oh the affiliated doctors office says, yes they will but only until July 1st.
Ummm, ok, my heads on a swivel to keep poachers at bay and trying to navigate the landmines....
Still this is why we get paid better than some other jobs....right? Right!
The good news is we are almost half way done.
And on the medicaid issues, yes, same here.....many don't have a card and generally can be taken up with the billing to add the medicaid. I've had one occasion though where I had to walk myself into the facility with a client in tow and talk to them myself about why is the medicaid not being billed as secondary.....got it fixed. Sometimes perseverence goes a long way. I did that one bc the doc office is not far from my house and neither was the client, and I live in a small rural community where this would be acceptable.
Yay!! Half way done....until you know, OEP begins until Mar 31st, which imo is going to be a cluster E#$#% as well.
Although I can't speak to SC, I can speak to MI
I'm also in my 3rd full AEP. Technically my 4th, but I didn't do much in 1st considering i was just getting contracted and wasnt even fully invested in it yet.
I thought this would be the best AEP ever. Yes, it is busy AF, and I'm writing non stop most days.
Heres how it's going with Humana and Aetna:
Prior to beginning of AEP, the major hospital network in my area is no longer in network for Aetna. Ok, so switch the client and move on.
Then a few days ago, now Humana is no longer in network.
Luckily I moved my Aetna clients to BCBSM.
But what happened to a colleague was she moved her Aetna people to Humana...and you can guess what happened there. Not fun.
It seems quite volatile this AEP. And I just shake my head when the FMO calls about "building and not moving people" or when they offer large amounts of coop money....yah, right....too busy working with currents.
And then I'm told, well the hospital network will bill out of network, then oh the affiliated doctors office says, yes they will but only until July 1st.
Ummm, ok, my heads on a swivel to keep poachers at bay and trying to navigate the landmines....
Still this is why we get paid better than some other jobs....right? Right!
The good news is we are almost half way done.
And on the medicaid issues, yes, same here.....many don't have a card and generally can be taken up with the billing to add the medicaid. I've had one occasion though where I had to walk myself into the facility with a client in tow and talk to them myself about why is the medicaid not being billed as secondary.....got it fixed. Sometimes perseverence goes a long way. I did that one bc the doc office is not far from my house and neither was the client, and I live in a small rural community where this would be acceptable.
Yay!! Half way done....until you know, OEP begins until Mar 31st, which imo is going to be a cluster E#$#% as well.
