What does CMS do??

[floridabroker]

this morning I had a member that had horrible service with UHC and was told her father is losing SNF benefits Nov. 18th.

She has left countless messages with no answers from UHC. BLAH BLAH.

I told her to lodge a complaint with CMS.

She called back 10 minutes later and the guy at CMS said that " He couldn't help her!" "UHC is a private company and they CMS can't do anything!"

So let me get this straight...

They can't help her because of a private company but they can demand a certain commission for us from a private company.

GREAT!

 

[retread]

this morning I had a member that had horrible service with UHC and was told her father is losing SNF benefits Nov. 18th.

She has left countless messages with no answers from UHC. BLAH BLAH.

I told her to lodge a complaint with CMS.

She called back 10 minutes later and the guy at CMS said that " He couldn't help her!" "UHC is a private company and they CMS can't do anything!"

So let me get this straight...

They can't help her because of a private company but they can demand a certain commission for us from a private company.

GREAT!

As an agent, you should know that a verbal complaint will get no satisfaction... tell her to put her complaint in writing. If you are selling MA products this consultation is required by law.

Perhaps you should review your "appeals and grievance" procedures and paperwork.

 

[floridabroker]

Retread,

I know the process.

We have had success in the past by going this route since UHC has such a horrible track record with us in service.

The point was the attitude.

Or did you miss this in the excuberance of trying to take a shot?????

 

[Slim]

I would try to call Customer Service for the client . Maybe do a three way. The problem in my opinion is the daughter called instead of the client. The SNF plan you mentioned was probably supposed to be SNP. ? .

If it is SNP the Company Customer Service will listen to you and have some info from their computer and will help. If the daughter is power of atty or responsible and the client is near the phone then you should be able to get some intelligent customer service if you are the writing agent and if you have the client's file and permission to delve into the matter.

If loss of SNP benefits is on 18th it sounds like an income issue or a residency issue. I may be wrong . I am not in FL but if you speak to the right person in the right way , in my limited experience , you will help the client with a call.

 

[Frank Stastny]

What does CMS do?

Does a rubber glove and a jar of Vaseline give you a clue?

 

[theinuranceguy]

What does CMS do?

Does a rubber glove and a jar of Vaseline give you a clue?

Castrate goats?

 

[Frank Stastny]

Castrate goats?

Only if you consider agents who work the senior market Goats.

 

[retread]

Retread,

I know the process.

We have had success in the past by going this route since UHC has such a horrible track record with us in service.

The point was the attitude.

Or did you miss this in the excuberance of trying to take a shot?????

1) If you know the process, why not follow it?

2) Past performance is no guarantee of future results. (sorry, couldn't help myself)

3) It is not a matter of attitude... he's got a point. CMS is not the place to start in the complaint department, you begin with UHC regardless of how painful it is.

4) Even though you butchered the word, I think you mean "exhuberence"... I can assure you I am not spending my time here trying to get my jollies... I am trying to help. I do get frustrated at times when people insist on trying to find a way around the rules and complain that they get rebuffed. Filing a complaint takes time... the rules are designed this way to cut down on the excessive belly-aching and whining. You can't blame them, if you could put yourself in their shoes for a moment. (then run!)

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