Integrity . But it’s not up to integrity wether they’re concerned with it . Carriers will get clarification from cms and what cms says all this means carriers must abide by it . It’s still cms’s call for what carriers can and can’t do .
Is the New 2025 CMS Rule for Agent compensation actually GREAT news for AGENTS and FMOs?
- Thread starter FMOadvisor
- Start date
This next song goes out to all the BFD's in the room . . .
But you do get paid for HRA's, right?
My understanding is that HRA's boost revenue for MA carriers. Is that correct?
If the HRA is never (or rarely) verified it certainly seems possible that carriers could collect additional taxpayer money for incorrect, falsified or embellished HRA's.
That certainly seems a logical conclusion. More HRA'a, more money for the carrier. What's not to love?
Feel free to jump in at any time with data.
I am willing to back off, just need some tangible evidence.
Perhaps you are right. Data? You don't seem like the type to BS their way through a discussion the way some of the agents do. When asked for supporting data they suddenly remember a tee time.
Aren't agents paid extra to complete an HRA? Seems like an incentive to me.
Risk assessment and risk adjustment are valuable tools
that are used for a variety of purposes in health care and
health insurance systems. They are used to adjust premium
payments to health insurance plans so that plans are not
over- or under-paid relative to the health of their enrollees.
How many times does CMS challenge the HRA?
Is this just a rubber stamp operation? Seems like it.
But you do get paid for HRA's, right?
My understanding is that HRA's boost revenue for MA carriers. Is that correct?
If the HRA is never (or rarely) verified it certainly seems possible that carriers could collect additional taxpayer money for incorrect, falsified or embellished HRA's.
That certainly seems a logical conclusion. More HRA'a, more money for the carrier. What's not to love?
Feel free to jump in at any time with data.
I am willing to back off, just need some tangible evidence.
Perhaps you are right. Data? You don't seem like the type to BS their way through a discussion the way some of the agents do. When asked for supporting data they suddenly remember a tee time.
Aren't agents paid extra to complete an HRA? Seems like an incentive to me.
Risk assessment and risk adjustment are valuable tools
that are used for a variety of purposes in health care and
health insurance systems. They are used to adjust premium
payments to health insurance plans so that plans are not
over- or under-paid relative to the health of their enrollees.
How many times does CMS challenge the HRA?
Is this just a rubber stamp operation? Seems like it.
I don't care what side of the fence you're on. That shit's funny.
InsuranceGuy29
Guru
- 661
Appeal it again, then. They'll get it.
More Health Systems Likely to Drop Out of Medicare Advantage, Analyst Predicts
Claims denials, prior authorizations are just some of the reasons, he says
www.medpagetoday.com
Ouch!!
I'm not going to try to dig up data on defending a hunch.
Pretty simple point I'm making: we as agents are in no way incentivized to in any way shape or form submit an inaccurate HRA.
Have you seen an HRA?
Pretty basic:
Do you have diabetes?
Do you have hypertension?
Do you have cancer?
Etc etc...
Feeling down on a scale of 1 to 10?
We get paid if everything is no. We get paid the same if everything is yes.
What data have you come across that indicates that an agent is incentived to embellish?
Man, it really is a small world.
