Secure Horizons Certification

[GreenSky]

Just did my certification for the next go-round. They have a few interesting statistics:

PFFS - 95% of docs agree to be deemed
90% of hospitals agree to be deemed.

That means that 1 out of 10 hospitals will not see the plan member!

Medicare - 22% have Medicare Supplement
18% have Original Medicare only

I don't know how many are Medi-Medi, but let's assume 20%? If that number is anything near correct, that means 40% are on some sort of an MA plan.

Also, it appears correct that CMS is requiring a face to face presentation. What about MY clients in different states that already trust me? Looks like I'm out of the PFFS business.

Rick

 

[policy doctor]

Well for those clients out of state, there are agents here who may be willing to accept a split commission and write them up. (something better than nothing).

And also this MA cirkus may be short lived if they don't get their funging.

Been on the radio all day about the HOUSE voting to decrease MA payments to pick up SCHIP coverage for children; which I understand would include families up to $80-100k income.

Give me a break....expanding that circle to the middle class means gov't just wants to control everybody's health care.

BTW...you can write hmo products over the phone, mail....ask AETNA.

 

[policy doctor]

Please excuse the type...i meant funding. Fingers got carried away.

 

[sman]

Also, it appears correct that CMS is requiring a face to face presentation. What about MY clients in different states that already trust me? Looks like I'm out of the PFFS business.

Rick

I didn't see that in there. As a matter of fact, under the heading:

CMS Required Elements for Enrollment:
The following information or "elements" must be provided or obtained for an enrollment to be considered complete and to be processed:

One of the bullets states the following:

Beneficiary Signature and/or Beneficiary Representative Signature (not required for phone or online enrollments)

Seeing that this is under the CMS Compliance section of the recertification, I would assume that a face to face meeting isn't required by CMS. Some of the material did state that you had to leave certain things with the client if you had a face to face meeting, but never did I see anything where it stated you had to have a face to face meeting.

In addition, none of the other recert's I've completed (Coventry and Humana) have stated that a face to face meeting is required.

 

[GreenSky]

I didn't see that in there. As a matter of fact, under the heading:

CMS Required Elements for Enrollment:
The following information or "elements" must be provided or obtained for an enrollment to be considered complete and to be processed:

One of the bullets states the following:

Beneficiary Signature and/or Beneficiary Representative Signature (not required for phone or online enrollments)

Seeing that this is under the CMS Compliance section of the recertification, I would assume that a face to face meeting isn't required by CMS. Some of the material did state that you had to leave certain things with the client if you had a face to face meeting, but never did I see anything where it stated you had to have a face to face meeting.

In addition, none of the other recert's I've completed (Coventry and Humana) have stated that a face to face meeting is required.

What I saw was that the PRESENTATION had to be done face to face, not the signature.

I hope what you saw was correct and what I saw from SH and Coventry was my mis-read.

Rick

 

[sman]

What I saw was that the PRESENTATION had to be done face to face, not the signature.

I hope what you saw was correct and what I saw from SH and Coventry was my mis-read.

Rick

I hope so as well. If I have to do it face to face, my MA production will reduce dramatically. I just went and looked at my MA clients. I have a total of 86. Of those I personally saw 13. There's no way I'm driving to see all these people. Some are 2 and 3 hrs away from me.

 

[IFS_Edge]

There is a Secure Horizon certification meeting mear me next Monday, am I going to have to do this in class? Or can I get the certification online?
Please let me know,
Laura