Providers are the link to this season with MAPDPs

Oct 15, 2007

  1. honestagent
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    honestagent Guru

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    We all know the providers are the critical link and key to a successful year for our clients and prospects.

    We also know not everyone can qualify for a med supp nor can some people afford one.

    A product on paper can look great; but if the doc. does not accept it - what good is it?

    I am wondering what would be the most efficacious way to ascertain docs in a network - hmo and ppo MAPDP. I am not talking about pffs.

    Just PPOs and HMOs. Any suggestions besides randomly calling from a listing of 'participating' lol phycisians?

    Directories... hmmmm....
    they are not always up to date and most of the time, it's mostly an advertisement tool rather than what it really should be-.. a directory of listed credentialed (if hmo) docs or listing of PPO docs - if applicable - assuming a kit would come with a directory for PPO or finding it on line.

    Does anybody have any proactive effitive solutions to research areas of participating physicians in advance?



    Thank you very much. -H.A.
     
  2. Kimber
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    Kimber Super Genius

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    I feel your pain. I have asked that question repeatedly to a number of carriers and unfortunately, the answers seem to go in circles. Typically, they say that they maintain a list of which providers have adamantly stated that they will NOT accepts payment of a particular carrier (or for that matter from any MA's), but no list of who WILL accept their terms.
     
    Kimber, Oct 15, 2007
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  3. senior-advisor-indiana
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    senior-advisor-indiana Guru

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  4. Kimber
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    I know... it's like an episode of "as the stomach churns..."
     
    Kimber, Oct 15, 2007
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  5. GreenSky
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    GreenSky Guru

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    I thought the original question was for PPO and HMO docs. I never trust the directories but go on-line to the various carrier's websites. They should be closer to up to date than any book.

    Also, when you are with the prospect, it shows that you care if you call the provider's office. I do that all the time.

    Rick
     
    GreenSky, Oct 15, 2007
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  6. senior-advisor-indiana
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    senior-advisor-indiana Guru

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    Do you really care though or are you just acting like you care?;)
     
  7. GreenSky
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    GreenSky Guru

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    I have to care. Otherwise I won't get the enrollment.

    Actually, by doing this, should there be an issue with their doctor in the future, they can't blame me!

    My problem is 2 days after I take the application, I've already forgotten the clients name. I'm getting too old for this!

    Rick
     
    GreenSky, Oct 15, 2007
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  8. senior-advisor-indiana
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    senior-advisor-indiana Guru

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    I was kidding Rick!
     
  9. honestagent
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    honestagent Guru

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    Rick or anyone else:

    Have you ever seen a name listed either on line or in the directory but oh no... guess what.... "we don't accept...." happen to you? IN other words, it was advertised as participating physician, yet the doctor's office have / had no knowledge they are a participant?

    If so, how do you handle in those cases?
     
  10. GreenSky
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    GreenSky Guru

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    There are two different ways to do this and they depend on why the client wants to see the doctor.

    1) Existing patient. Usually the physican is closed only to NEW patients.
    2) New patient. Find another doctor.

    If we're talking PFFS, I always contact their doctor first. If the doctor doesn't accept the plan it's usually because they don't understand how it works. After a little discussion and sending information, most times they change their mind. If they still don't accept, try to reduce the cost of the Med Supp.

    Rick
     
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