Is an MA Carrier REQUIRED to Send APP INFO the Enrollee?

Oct 29, 2016

  1. wehotex
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    wehotex Guru

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    I just enrolled a customer for a 9-1-16 effective date with Humana Gold Plus HMO. I just called to check up on her and found out that somebody called her on the phone, asked her if she was diabetic and supposedly enrolled her for the special needs Diabetes Chronic plan for an 11-1-16 effective date. That steals the Agent of Record status for me. Honestly, if there had been an advantage with that particular plan, I would have put her with it!! Is Humana (or any MA carrier) required to provide her with a copy of a paper app with her specific enrollment information on it? I'm really trying to find out the agent's name. This member did not call anyone. They called HER. I'm going to visit with her on Monday, but I'd really like to know who did this.
     
    wehotex, Oct 29, 2016
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  2. jacobtn
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    That doesn't take AOR from you if it's HMO>HMO. only if it's HMO>PPO or PFFS. original agent retains AOR.

    You can always call customer service with her and they will tell her who the agent that wrote the SNP was.
     
    jacobtn, Oct 29, 2016
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  3. MedicareAgent
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    Aren't you required a signature on Humana??
     
  4. wehotex
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    wehotex Guru

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    It DOES take AOR from me. Humana changed it a couple of years ago.

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    ANY change will change AOR. It used to change AOR when the Contract prefix numbers were different. Ex: R6801-091 --> H2649-046 or vice versa.
     
    wehotex, Oct 29, 2016
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  5. Chazm
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    Chazm Guru

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    Sounds like Humana just made an outbound call to the client. Happens all the time. I bet if you call Humana you're still the AOR
     
    Chazm, Oct 30, 2016
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  6. wehotex
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    wehotex Guru

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    I think that you are right. When I called Humana this morning, I was told that I was still the AOR. Mb did not have any info about the "new" plan at her house. I showed her what to look for when she gets her new 2017 card, just in case.
     
    wehotex, Oct 31, 2016
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