Is anyone else out there losing Advantra Freedom MA clients during verification calls

[samantha129]

Re: Is anyone else out there losing Advantra Freedom MA clients during verification c

Me thinks CMS goes out to happy hour on Friday and after a few drinks they try to come up with ways to make it harder on the seniors as well as everyone else.

Many of my clients are fearful of PFFS. CMS needs to make a stand on PFFS and state that if your a provider that accepts Medicare then your required to accept PFFS.

None of this BS that they'll accept one day and the next they may not or better yet we'll accept you and not your neighbor even though there on the same PFFS plan. Granted, a provider would be nuts to do this but the fact that it's a possiblity is crazy!

 

[Bob_The_Insurance_Guy]

Re: Is anyone else out there losing Advantra Freedom MA clients during verification c

Me thinks you have it all wrong. It is called "PRIVATE FEE FOR SERVICE" for a reason. Just as noone can force you to work with a client from year to year, this is allowing physicians to pick and choose who they want as clients.

Once you write a small group, are you "FORCED" by any legislative body to keep that client on the books? Absolutely not. If you've been in the industry for any length of time, you have probably "fired" a client.

Let me repeat, this is PRIVATE fee for service, not FORCED fee for service.

I have two parents who are both on Medicare, and I can tell you, as their son, and their insurance agent, I am glad that these safeguards are put in place. As I said earlier in the post, once we stop abusing this segment of the population, then the restrictions will be lifted.

Do I like CMS No.

Do I like working with FMO's and folks like Parker and Associates to get paid? No.

Am I smarter than CMS, and use what they don't think of to my advantage? Yes.

Do I like Medicare Advantage Plans? Yes.

Do I like Medicare Supplement Plans? Yes.

 

[GreenSky]

Re: Is anyone else out there losing Advantra Freedom MA clients during verification c

CMS has forgotten (or never knew) that MA plans are supposed to provide a benefit. CMS seems to think their only purpose is to protect seniors from something that might be of benefit.

There are 2 sides to everything - in this case benefit vs. taking advantage of a senior. CMS does not care about the former.

Rick

 

[retread]

Re: Is anyone else out there losing Advantra Freedom MA clients during verification c

(One of ) The problem(s) I see with CMS and their position on provider freedom to reject PFFS clients is exactly the point brought up about the provider being able to choose which clients they want to accept.

On the one hand, CMS grants this privilege, and on the other makes it a crime to "cherry-pick". Their own regulations pave the way to "cherry-pick".

 

[beatuplunchbox]

Re: Is anyone else out there losing Advantra Freedom MA clients during verification c

Just have a quick updete about they coventry thing...

I had a couple that I had signed up for the PFFS plan call me today and told me that they had used their coventry card a couple of weeks ago and were now being told that they were never properly enrolled. I checked my statements and their there names were, dissenrolled-verification call! They acted suspicious of me but I appologised and had it on the paper in front of me.

I wonder how many others are now disenrolled because of that verification call and don't even know it?

I'll probably end up looking like the world's biggest *** to a lot of them when this is over.