SCOPE 48 Hours Rule ?

Mar 7, 2016

  1. Farmgirl
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    Not sure with CMS rule?
    Client calls and wants to talk med sup/med advantage in appointment.
    Do I need to get scope 48 hours before meeting her to discuss or is it ok to obtain scope during appointment ?
    Thanks
     
  2. Newby
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    Yes you need to get a scope signed 48 hours in advance of face to face meetings. In your required training and testing to sell MA they go over that multiple times.
     
    Newby, Mar 7, 2016
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  3. GreenSky
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    Not correct. You can make a next day or same day appointment and indicate that on the scope. Same with walk-ins. You are not required to make them sit in your waiting room for 2 days.

    Rick
     
  4. Newby
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    Walk in's I agree with but if they already indicated to you that they want to meet it's not a walk in. CMS requires a scope 48 hours in advance except if there is a reason that is not possible or reasonable.

    It's not my rule. It's CMS's
     
    Newby, Mar 7, 2016
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  5. GreenSky
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    Correct. If someone wants to see me tomorrow I don't have 48 hours for a SOA. Therefore it's not possible nor reasonable.

    You're statement was that you needed a scope 48 hours in advance without clarifying that it's easy to get around by simply having next day or same day appointments.

    Rick
     
  6. Farmgirl
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    yes I know about the 48 hour rule in general. But I thought there were exceptions ( walk in ....) I guess my question is even if the client requests the appointment longer then 48 a head of time if it is needed ( Rick thanks for the reply) .
    Trying to get client to get scope to me before ...not sure if it will work since she has not internet.
     
  7. GreenSky
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    Exactly. It's just amazing that every one of my scopes answers the question as to why it wasn't signed 48 hours in advance with "Next Day appointment." I guess I just don't make appointments very far in advance.

    Rick
     
  8. axeman462
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    There are local MAPD's in Florida that train that the 48 hour rule is just a suggestion. They even train their captive agents commonly do a voice SOA over the phone, on the way to the appointment.

    And if memory serves my right, during SOA training in (I think) AHIP, the wording "when convenient" is used when referring to the 48 hour rule.
     
  9. Newby
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    As the Mayer of California I assume you have it correct.

    But the actual CMS rules do say to have the scope signed 48 hours in advance when possible.
     
    Newby, Mar 7, 2016
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  10. ICACharleston
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    Has anybody actually had to produce a SOA from an old appointment? Let alone 'splain any details? I remember a local plan not accepting apps without scopes but that's all.
     
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