The Health Plan – Member Costs Waived for COVID-19 Testing

The Health Plan Will Waive Member Costs for COVID-19 Testing

 

The Health Plan announced today it will cover the cost of copays, co-insurance, and deductibles for COVID-19 testing for all Commercial, Medicare and Medicaid lines of business when recommended by a medical professional. Our exclusive independent lab provider, LabCorp is making its NAA test available for ordering by physicians or authorized healthcare providers anywhere in the United States.

For The Health Plan’s self-funded (ASO) members, they will also waive cost-sharing for diagnostic testing related to COVID-19, unless they receive notice in writing of the group’s intent not to implement this temporary relief option.

The Health Plan wants to provide members with peace of mind. “Supporting the health and well-being of our members is important to us. We want to assure our members that we will do all we can to make health care treatment and services available to them at no additional cost, especially for seniors and people with chronic conditions,” said Jeff Knight, Interim President/COO of The Health Plan.

At this time, the Centers for Disease Control and Prevention (CDC) and state labs currently performing the testing are not billing for COVID-19 testing, so members should not incur costs when tested by these labs.

The Health Plan remains committed to ensuring access to medications is available during this time. Members have multiple options to obtain medication through The Health Plan, including the ability for Medicare and fully-insured members to fill 90-day supplies of long-term medications via mail order or local retail pharmacies. The Pharmacy Services Department will be available to assist with any extenuating circumstances such as ensuring formulary flexibility if medication shortages or access issues arise.

The Health Plan recommends contacting your doctor’s office first if you suspect you might have a flu or coronavirus infection. But to help reduce potential exposure, The Health Plan also encourages members to utilize telemedicine services if they are available as part of a member’s plan. The Health Plan will waive member cost share where applicable for telemedicine visits for the next 90 days. Telemedicine is a safe and effective way for members to see a doctor to receive health guidance related to COVID-19 from their homes via smart phone, tablet or computer-enabled web cam.

The Health Plan is providing the latest information on precautions members should take to help prevent the spread of COVID-19 and who should seek medical attention on their website. Visit healthplan.org for more information.

Update – Humana’s Agent Technology Tools

Update on Humana’s Agent Technology Tools

In these unique times, we have provided guidance to our agents to avoid face-to-face meetings and appointments with our consumers. Last week, we sent a communication outlining our request to reduce paper applications. Today we want to reiterate that Humana has an approved telephonic sales presentation process and electronic tools that will enable you to continue to sell and service consumers, which will further reduce our reliance on paper.

  • For career and field-based external partners, you should be leveraging Enrollment Hub now more than ever! This tool offers streamlined enrollment applications that allow electronic signatures, so the need to meet face-to-face can be alleviated, and links to Med Supp and IDV are also available within this tool.
  • Agents can also leverage Direct Marketing Materials (DMM) for Medicare and Agent Online Application (AOA) for Medicare and IDV applications when working virtually.
  • We also want to take this opportunity to remind you of the important steps you must follow to conduct a compliant telephonic sales presentation. Click here to learn more.
  • For English speaking consumers that do not have email addresses or want to enroll in a CarePlus plan, agents may now leverage IVR signature within FastApp.
    • On Step 8 of the application, career agents should select Affinity ID “Field Agent IVR” and that will offer the correct signature types. External Agents should select the Affinity Code based on the partner you are aligned with. If your agency is not listed, please select “Field Agent IVR”
    • Agents should elect to be notified about abandoned or successful IVRs via the checkbox under Agent Email Address. You can also look for these applications in VANTAGE Business Center 24-72 hours after submission.
    • Job Aid with More Details: FastAPP IVR Process for Career and Partner Agents
  • Beginning at 9am EST on 3/24/20, for Spanish speaking consumers, please leverage the assisted telephonic signature (T-sig) process via Direct Marketing Services (DMS). The field agent will complete the electronic application, save it, and then call DMS to do the telephonic signature.  Below are the steps that will take place:
    • Field agent makes sales presentation over the phone.
    • If consumer consents to enroll, field agent fills out the application in FastApp through the link in Vantage, and then saves it.
    • Field agent will call & conference with DMS via 1-800-833-6573 with the enrollee on the line. THIS NUMBER IS ONLY TO BE USED FOR SPANISH ENROLLEES.
    • Once all three parties are on the line (field agent, DMS agent and the enrollee), DMS will complete the signature using T-sig, and drop from the call. The field agent will then complete the call.
    • Compliance Reminder!  Agents may not coach the enrollee through the T-sig process by telling them to “just say yes to everything”, for example.

Aetna Remote-Selling Tools (ekits and RATE)

Try these remote-selling tools (e-kits and RATE)

Do you have clients who want to move forward with enrollment, without having an agent enter their home? For Aetna Medicare (MA/MAPD) and SilverScript PDP products, there are two tools you can use: e-kits and the Remote Agent Telephonic Enrollment (RATE) tool. To use either option, you must have access to the Ascend Virtual Sales Office app; to get access, fill out an Ascend app request form on Producer World. (Please note that it can take up to 2-7 days to process new user requests for Ascend.)

Tool
Why use it? 
Requirements
e-kits
Allows your clients to enroll online and maintain you as their writing agent
•   You must have access to the Ascend app

•   Works on any laptop or iPad mobile device

•   (No special set up or extra training required)

Remote Agent Telephonic Enrollment (RATE) tool
Allows you to obtain a complete, compliant enrollment entirely by phone
•    You must have an iPad to use the RATE tool; it is not compatible with other tablet brands

•    You must have access to the Ascend app
•    You must complete an online, self-paced compliance training and pass a quiz with a score of 90% in two tries or less

UHC LEAN Complete User Guide

Access the complete UHC LEAN User Guide for online and remote applications.

LEAN_User_Guide

Wellcare COVID-19 Updates and Talking Points

Source:  WellCare Agent Advisory March 20, 2020 5:39 pm

COVID-19 Updates and Talking Points

In this time of uncertainty, staying informed is essential. Therefore, we will regularly communicate updates and talking points. Rest assured, we are still closely monitoring the coronavirus (COVID-19) situation and are engaging regularly with medical professionals, the Centers for Disease Control (CDC), the World Health Organization (WHO), and other government agencies, as the situation evolves.

Helping Members Feel Supported

With so many things changing, it is important that our members know they are supported. We are here to help members manager their conditions and stay healthy.

Medication

  • Members can fill prescriptions early, if needed.
  • Many pharmacies are offering free local delivery. If a member’s pharmacy isn’t offering free local delivery, they should consider CVS mail order or another local pharmacy (of the members’ choice).
  • Convert medications to 90-day supply home delivery.
  • This process can take time, will generally require providers to be involved, and requires time for mail delivery.
  • There are two ways to set up 90-day supply home delivery: visit the CVS website www.Caremark.com or call 1-866-808-7471 TTY: 711

Food & Basic Essentials

When in need, we are here to help and connect members to our Community Connections Help Line, who help members find local resources. The Community Connections Line is 1-866-775-2192, TTY: 1-855-628-7552. Please understand, this service is experiencing higher than usual call volumes and higher demand on all supplies. We will continue to work with our members to meet their needs as best as possible.

When to Call a Doctor

If your member thinks he/she has been exposed to COVID-19 and develop a fever and symptoms, such as cough or difficulty breathing, advise them to call their healthcare provider for medical advice.

Key Reminders:

Telephonic MAPD Marketing Presentation

Due to the current state of COVID-19 as of 3/16/2019, WellCare will allow agents to conduct telephonic MAPD sales appointments with beneficiaries!

Remember, when conducting telephonic MAPD marketing presentations to Medicare prospects seeking only MAPD information; all current CMS Medicare Marketing Guidelines, WellCare policies, etc. must be followed.

MAPD Telephonic Marketing Presentation Dos and Don’ts

After all CMS requirements are met including consent-to-contact and SOA, an agent may proceed with a telephonic MAPD marketing presentation and assist with a formulary/physician searches.

If the prospect agrees to enroll, the agent MAY:

  • Provide PURL information to the prospect; or
  • Send paper application (and all required documents) to be completed by the prospect

If the prospect agrees to enroll, the agent MAY NOT conduct telephonic enrollments on behalf of the prospect

Protecting our members, employees, and partners conducting home visits

  • Centene is taking steps to cover COVID-19 testing and screening services for Medicaid, Medicare, and Marketplace members and is waiving all associated member cost share amounts for COVID-19 testing and screening.
  • We will not require prior authorization, prior certification, prior notification, or step therapy protocols for COVID-19 testing and screening.
  • Enhanced protocols have also been created to ensure our pharmaceutical services continue to be available for members through supply chain management.
  • To lower the risk of transmission of illness we suggest taking precautions, such as reaching out by telephone prior to home visits to ensure that those being visited are not experiencing any symptoms related to COVID-19. As always, please ensure to adhere to all CMS guidelines.

Hours of Operation:

Presently, all call centers will be operating business as usual. As our country continues to prepare and execute safety measures, we will continue to evaluate business processes that will ensure the safety of all partners.

We encourage you to reference the Centers for Disease Control and Prevention (CDC) website as well as local government guidance for current updates.

Further, ensure to use the following precautionary measures to support a safe and healthy environment:

  • Thorough hand washing with soap and water for at least 20 seconds — hand hygiene is the most effective method to control the spread of many viral illnesses.
  • Using alcohol-based (containing at least 60 percent) hand sanitizer.
  • Covering your mouth when you cough or sneeze by coughing and sneezing into a tissue and then disposing of the tissue in a wastebasket.
  • Thoroughly cleaning surfaces that may be contaminated.
  • Avoiding shaking hands and close contact with people who are sick.

We appreciate your cooperation and support in serving our members and communities in this time of need and uncertainty. As the situation evolves, please know that additional measures will be taken with a local-oriented approach, and we will continue to ensure our employees and partners are supported and safe.

As always, thank you for all that you do to transform the health of our communities and your dedication to our underserved and vulnerable populations. You are making a difference and you are relied upon more than you may realize.

Allwell’s COVID 19 Updates and Procedures

Monday March 23, 2020

Dear Allwell Broker

Thank you for all that you do to transform the health of our communities and your dedication to our under served and vulnerable populations, particularly in this time of uncertainty.

Our teammates and partners are the heart and soul of this organization. The health and safety of our employees, partners, members, and communities is our uncompromising priority. We are closely monitoring the coronavirus (COVID-19) situation and are engaging regularly with medical professionals, the Centers for Disease Control (CDC), the World Health Organization (WHO), and other government agencies as the situation evolves.

 

Company leadership, our business resilience teams, and representatives from across our businesses are engaging daily to monitor the situation as it evolves and are taking measures to keep employees and partners safe, minimize the risk of exposure to COVID-19, and ensure that we can continue to provide the services that our members rely on for their health and well-being. That said, Centene would like to offer some options on how to keep you and your clients safe while still making sure business is being conducted.

 

Telephonic MAPD Marketing Appointments

Due to the current state of COVID-19 as of 3/16/2019, Centene will allow agents to conduct telephonic MAPD sales appointments with beneficiaries.

Remember, when conducting telephonic MAPD marketing appointments with Medicare prospects seeking only MAPD information; all current CMS Medicare Marketing Guidelines, Centene policies, etc. must be followed including consent to contact and documented Scope of Appointment. The Scope of Appointment (SOA) can be initiated via email or text through the Ascend application and must be in an ‘accepted’ status prior to discussing any plan information. If your client does not have access to email or a method of texting traditional paper SOA forms are required.

 

After all CMS requirements are met, an agent may proceed with a telephonic MAPD marketing appointment and assist with a discussion of plan details and formulary/physician searches. Please use the presentation checklist as a way to ensure that all important topics are covered.

 

If your client agrees to enroll, the agent may:

·    Use Remote Agent Telephonic Enrollment (RATE) within the Ascend Online Enrollment Platform (must be an enrolled Ascend user)

·    Provide their Ascend PURL information to the client; or

·    Send a plan Enrollment Guide which includes a paper application (and all required documents) to be completed by their client

 

Remote Agent Telephonic Enrollment (RATE)

RATE is a powerful enrollment tool within the Ascend Mobile Application (AMA) that enables you to enroll your clients by phone. The platform will allow you to enroll your clients and still initiate a Value Based Enrollment (VBE).

 

Some important things you should know are:

·    RATE is only available with an iPad and runs on iOS technology.

·    Check that you have the latest version of iOS installed on your iPad.

·    You must have the latest version of Ascend – you can do this by logging into Ascend and it will ask you to download the latest version.

·    Verify that your Ascend Resources are up to date. You can check this by clicking on “Resources” and confirming that “Resources are up to date” in the top right-hand corner of the application.

·    Once in the Ascend Mobile Application (AMA) make sure that you click the drop-down menu under your name in the top right-hand corner of the application and choose “Accepting Calls.”

·    Disregard the “Unavailable” section in the drop down menu.

·    Telephonic sales must be done using RATE only.

·    Confirm that your RATE access is functional and that you have your unique 1-800 number found in the same drop-down menu next to “My Number.”

·    If you are conducting a telephonic sale, appointments must get a documented Scope of Appointment (SOA) prior to starting the appointment.

·    You can NOT initiate or accept a RATE call if you are already in a scheduled meeting.

·    Your iPad should be used in landscape mode, this will ensure that you can view the “Start Meeting” button.

·    You MUST follow the approved RATE script – all phone calls are recorded.

·    The RATE script should be downloaded to another device or printed out as the script cannot be viewed on the same iPad screen.

·    Agents should review the entire RATE script prior to using RATE for the first time and be aware of all statements that must be covered including those that MUST be read verbatim.

·    You can NOT initiate Blue Button using RATE.

·    Make sure that the enrollment is complete prior to initiating the VBE. If selecting “Call Now” for VBE, ensure that you have wrapped up conversations with your client as they will be called immediately after clicking “Call Now”.

·    Once your RATE enrollment is complete send an enrollment guide to your client to ensure they have access to important and required documents.

 

For further information on RATE please download the following documents

 

RATE Training

 

RATE Best Practices

 

RATE Approved Script ENGLISH

 

RATE Approved Script SPANISH

 

RATE Tutorial Video

 

Personalized URL

Every agent who is registered to use Ascend has a Personal URL (PURL) that you can use to connect your client with the Ascend online enrollment tool if you are not able to do a face to face meeting.

 

The PURL can be found in the Agent Portal (tile on the home screen of AMA) and accessed with the same Ascend credentials. Your PURL can be sent electronically to your client who wish to do an online enrollment on their own.

 

Some important things you should know are:

·    Your PURL is unique to you and is created on your first login to the agent portal (once you login click on “View Enrollments” and the PURL will be at the top of the page).

·    The PURL is attached to your writing numbers so that you will get credited for the sale when an enrollment is made through the tool.

·    The Ascend Quote and Enrollment tool will look the same for the agent as it would in the AMA, however, lead information and other items like Scope of Appointment will not be merged into the application.

·    VBE and Blue Button are NOT options when using your PURL.

 

While we are in unprecedented times it is important that to take precautionary measures to keep yourself and your loved ones safe so please use the alternative enrollment options whenever possible.

 

Paper Application

If you are sending an Enrollment Guide with a paper application, make sure that you complete the Office Use Only section including your name and NPN. Do not fill out the received date.

 

Special Enrollment Period (SEP) for Beneficiaries affected by COVID-19 (Coronavirus)

The COVID-19 pandemic is declared a national emergency with incidents declared on the FEMA website for all US states. Therefore CMS guidelines surrounding Special Enrollment Periods will be in effect. If your client or client’s authorized representative has been affected by COVID-19 as documented by FEMA and were not able to enroll, dis-enroll, or switch their Medicare health or prescription drug plan during another valid election period due to the national emergency, they will have a Special Enrollment Period (SEP) that is currently available.

 

For more information about COVID-19 SEP please visit: https://www.fema.gov/disasters

 

Hours of Operation:

As of now, all call centers will be operating business as usual. As our country continues to prepare and execute safety measures, we will continue to evaluate business processes that will ensure the safety of all partners.

 

Protecting our members, employees, and partners conducting home visits:

Centene is taking steps to cover COVID-19 testing and screening services for Medicaid, Medicare, and Marketplace members and is waiving all associated member cost share amounts for COVID-19 testing and screening.

We will not require prior authorization, prior certification, prior notification, or step therapy protocols for COVID-19 testing and screening.

Enhanced protocols have also been created to ensure our pharmaceutical services continue to be available for members through supply chain management.

To lower the risk of transmission of illness we suggest taking precautions, such as reaching out by telephone prior to home visits to ensure that those being visited are not experiencing any symptoms related to COVID-19. As always, please ensure to adhere to all CMS guidelines.

 

We encourage you to reference the Centers for Disease Control and Prevention (CDC) website as well as local government guidance for current updates. Further, ensure to use the following precautionary measures to support a safe and healthy environment:

·    Thorough hand washing with soap and water for at least 20 seconds — hand hygiene is the most effective method to control the spread of many viral illnesses.

·    Using alcohol-based (containing at least 60 percent) hand sanitizer.

·    Covering your mouth when you cough or sneeze by coughing and sneezing into a tissue and then disposing of the tissue in a wastebasket.

·    Thoroughly cleaning surfaces that may be contaminated.

·    Avoiding shaking hands and close contact with people who are sick.

 

We appreciate your cooperation and support in serving our members and communities in this time of need and uncertainty. As the situation evolves, please know that additional measures will be taken with a local-oriented approach, and we will continue to ensure our employees and partners are supported and safe.

 

If you have any questions regarding the above information please reach out to your local Account Executive or to our Broker Services team at 1-844-202-6811 Monday through Friday, 9:00am to 5:00pm all time zones.

 

Thank you for your continued support.

 

Allwell

 

Approval ID: SCApproved-320-EFT-20200320

Disclaimer: For Agent use only – Not approved for presentation or distribution to Medicare beneficiaries

MMO’s NEW MA Electronic SOA Now Available!

Medicare Advantage Electronic Scope of Appointment Now Available

Date: March 20, 2020
Category: Enrollment
Applies to: Medicare AdvantageAs we all work to adapt to the ongoing coronavirus disease known as COVID-19 changes, we are implementing new, temporary business procedures to ensure that you have what you need to continue to do business. Effective immediately, you are now able to send and receive a Scope of Appointment (SOA) via email. This will help you assist your customers, while remaining compliant, without having to meet face to face or requiring a printed SOA form.

Steps for sending an electronic SOA

  1. Send your client an email with the required information. See example email here. Please note: The sections highlighted in yellow should be customized for each client before you send the email.
  2. Have your client reply to your email with “I agree” in the body copy.
  3. Once you have your client’s permission, you can send the enrollment application.
  4. Use this online enrollment guide for quick tips on how to send applications to members.
  5. Make sure you save the email correspondence, as we will be conducting random audits to ensure this process is compliant. You do not need to submit copies of the emailed SOAs unless requested.

As a reminder, you can also submit Medicare Supplement applications through the same online enrollment tool. Medicare Supplement applications do not require a SOA.

Still have questions?
Attend one of our upcoming webinars for more information on the online application process. You can also contact your individual Account Manager with any questions.

Upcoming Webinars

Tuesday March 24, 2020 at 10am
Meeting ID: 922 514 984
Join Meeting

Thursday March 26, 2020 at 10am
Meeting ID: 926 678 879
Join Meeting

Thursday March 26, 2020 at 2pm
Meeting ID: 926 005 988
Join Meeting

Contact your Account Manager

Mike Broderick
Account Manager
419-595-6366
Mike.Broderick@medmutual.com

Steve Cooley
Account Manager
614-378-4571
Steve.Cooley@medmutual.com

Jennifer Detrick-Myers
Account Manager
513-684-8199
Jennifer.Detrick-Myers@medmutual.com

Amanda McFarland
Account Manager
440.572.6367
Amanda.McFarland@MedMutual.com

Anthem’s Limited Agent Support Center Staff

A Message from Anthem as of 3/19/20:

During these times of change, Anthem asks that you be patient with. As of yesterday (3/19/20) California has issued a statewide shelter. Our Medicare Agent Support center is based in California. This will reduce the number of agent services representatives we have available. Wait time will be longer than normal.

To help with the wait time we ask that you use the DSNP Validation tool. Also, email issues when you can. Please add member name, id, and dob with any details you can provide.

In the wake of these unprecedented times we appreciate your patience and partnership.

 

If you have any questions please reach out to your CSM rep

UCT’s Online Enrollment Process

UCT provides you with products that can be written through electronic applications on your computer and submitted through your email directly to UCT!

Read full message here

Humana Requesting Submission of Online Enrollments

Humana has a strong commitment to the health and well-being of our members, associates, and agents. At this time of rapidly changing information and concern about the coronavirus disease 2019 (COVID-19), Humana is putting measures in place to help provide a safe workplace and maintain our ability to care for members.

Enrollment Application Submission Options

We have made great strides over the last year in reducing the amount of paper applications submitted and promoting the use of electronic enrollment channels driving faster enrollment, better visibility to agents, and a more seamless onboarding experience for members. In an effort to minimize utilization of the postal system and our vendor partners, we are strongly encouraging the use of electronic channels for application submission.  Additionally, the electronic channels have historically lower error rates and will be processed faster and more efficiently than paper applications, reducing the overall stress on the enrollment process and provide faster access to care.

Effective immediately, we are requesting that agents submit enrollment applications using our Enrollment Hub or FastApp electronic tools, with the prospect/member’s permission.  

If a paper application is necessary, we are requesting those be submitted using:

  • Vantage Upload Paper Application form (Click here for instructions)
  • Humana Enrollment Document Transmitter App (see instructional video here)
  • Fax- 1-877-889-9936

During this time, agents should NOT mail paper applications, as postal service delays or vendor limitations that prevent our ability to receive and process these applications are possible.

Your cooperation is appreciated as we strive to provide the best member experience and avoid disruption in care. We will continue to keep you updated about when we expect to resume our standard operating procedures.