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[DonP]

I haven't used Connecture in a couple of years, but I thought it was slow, and I don't want my client's info on there. Not that I don't trust Integrity.

If you’re under an integrity fmo they have all your clients info wether you use Connecture or not . It’s really irrelevant anyway . The carriers and 1000 other people are calling them anyway

 

[rmhaire]

If you’re under an integrity fmo they have all your clients info wether you use Connecture or not . It’s really irrelevant anyway . The carriers and 1000 other people are calling them anyway

Afraid not. I use 4 different Integrity fmos and neither one knows what the other ones and I are up to.

As far as Connecture, you get it from only one fmo and the carriers you can quote are specific to each fmo.

 

[sshafran]

The reason I use it is not because I'm worried about integrity taking my clients. I use S&S because it shows all plans and it's a central database that I won't need to move in the future if/when I change up lines.

As far as accuracy goes - I've gone away - on purpose - from predicting most things. And in 2025 and beyond this will be even more important. I have memorized (not that hard) about 6 PDPs "structure" i.e. Tier 1 $0, Tier 2 $5/mo Tier 3 25% Tier 4 50% Tier 5 25% Tier 6 $11.

Then I just use S&S mainly to get rough estimate on which to even look at and tier levels.

But all I'll ever tell them is premium, ded, what tiers their Rxs are, and the initial coverage chart, and short exp of gap. Period - that's it. No "yearly estimate" crap.

No one needs that and it is absolutely outside the scope of our role. Our role is to explain the insurance. Not predict coinsurance or yearly cost.

Similarly, I don't look at them and say, hey Johnny looks like you might need a new hip this year so I'm estimating your medical out of pocket to be $874.33 with Humana GP but Aetna we'll estimate your new hip at $798.22 - so let's do Aetna.

 

[kgmom219]

I’m in love with S and S. I would marry it, but I’m already taken.

This is a Part D only review.

I. We emailed the clients the link in Sept and got a 80% completion rate (after we figured out it doesn’t work on phones very well)
2. Part D runs 80/20. 80% of clients don’t hit a $500 threshold. This year (I have trust issues), I ran all 80% in S and S AND Medicare.gov. Not a single error.
3. The 20% are going through Medicare.gov. I want the backup if there’s an issue.
4. We are currently cleaning up S and S, because it also works in reverse. We can send the current lists out and ask for a review in Sept.
5. Because I’m going after current MAPD people this year, we will use it to weed out options based on providers. The online directories are wrong IF you are trying to confirm a provider is IN network. But if they don’t show up, 99% of the time, they aren’t in network. “Dr Smith is not available for Humana but the online directory says that they are in BCBS. Please call the office to confirm. I’m sorry that we won’t do it for you, but it’s because if they tell me yes and it turns out it’s a no, I get in trouble with my clients”. Same thing in ACA. It works.

I resisted a long time. I wish I had done it sooner.

 

[Chazm]

S&S is highly accurate and I love it for the doctor lookup. But, wow, it’s annoyingly slow.

 

[DonP]

Afraid not. I use 4 different Integrity fmos and neither one knows what the other ones and I are up to.

As far as Connecture, you get it from only one fmo and the carriers you can quote are specific to each fmo.

You misunderstood what I said . The main nmo (Integrity ) has all your clients regardless of what integrity fmo your under . 80% of my enrollments are threw the carrier but the total # of my clients still show up as my total # of actives on the front page of Medicare center . Like I said carriers and 1000 call centers calling your clients anyway

 

[sshafran]

Bumping this thread.

They did a big upgrade - I didn't attend the webinar but my assistant did and the new provider integration is - I think - a nice enhancement.

For those who use Health Sherpa - it's a similar type setup.

You load providers in - then when the plans come up - there is a new column now with doctors and a number. The number in the column is how many doctors take the plan.

I did a test.

I put in the local favorite PCP who takes all plans in my county (we don't have a lot). Then, I put in a provider in a different state - just to play with the system.

It showed - our our local HMO - it showed 1 - then you can click it and see that he is in, but the out of state doc is not.

But then on a PPO - it showed 2 - since the doctor in the other state is in that carrier's national network.

Man, that's nice. I like it.

I didn't really use their provider lookup much but I like this new interface.

I think this upgrade will be good!

 

[Chazm]

Bumping this thread.

They did a big upgrade - I didn't attend the webinar but my assistant did and the new provider integration is - I think - a nice enhancement.

For those who use Health Sherpa - it's a similar type setup.

You load providers in - then when the plans come up - there is a new column now with doctors and a number. The number in the column is how many doctors take the plan.

I did a test.

I put in the local favorite PCP who takes all plans in my county (we don't have a lot). Then, I put in a provider in a different state - just to play with the system.

It showed - our our local HMO - it showed 1 - then you can click it and see that he is in, but the out of state doc is not.

But then on a PPO - it showed 2 - since the doctor in the other state is in that carrier's national network.

Man, that's nice. I like it.

I didn't really use their provider lookup much but I like this new interface.

I think this upgrade will be good!

It’s a nice upgrade but still pretty buggy. I entered three doctors. My plans available were reduced to 36 plans that accept those doctors. The client told me she really only needs two of those doctors, so I took out one.
Somehow it was then reduced to 20 plans that accept those two doctors.
Then I took out one more doctor and it was reduced to zero plans available.

They have some work to do. But, once fixed, it will be great.

 

[sman]

It’s a nice upgrade but still pretty buggy. I entered three doctors. My plans available were reduced to 36 plans that accept those doctors. The client told me she really only needs two of those doctors, so I took out one.
Somehow it was then reduced to 20 plans that accept those two doctors.
Then I took out one more doctor and it was reduced to zero plans available.

They have some work to do. But, once fixed, it will be great.

Not only buggy, but now you have to re-enter all doctors from previously saved lists and then drag and drop them to the CPC/Specialist section. And the system moves slow when doing this so this will be very time consuming. I don't know how long this is going to take, but my recommendation would be to do it prior to AEP.

Edit to add - @Chazm, did you create a ticket for the change in plans when you removed a doctor?

 

[kgmom219]

Still though is it very time consuming slow

im going to probably try free trial

You won’t look back.

It’s slow. But the accuracy was 100%. I checked anyone over $1K in total costs last year.