Anthem News – Bon Secours Mercy Health Update

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Bon Secours Mercy Health is staying in Anthem’s Medicare Advantage network in Ohio.

Anthem announced that they reached an agreement with Bon Secours Mercy Health to keep them in their Medicare Advantage network. They have secured a a new long-term contract, ensuring members will have in-network access for years to come.

Anthem is sending letters to impacted members to share this good news. If members already moved to a new provider, they can stay with them or switch back to Bon Secours Mercy Health.

Please visit anthem.com/MercyHealthOhio for the latest information.

More Stores Are Now Available With Anthem’s Grocery Benefits

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Sourced from Anthem broker eblast on 9/11/23:

Anthem Medicare Advantage members now have more choices when using their Grocery benefit allowance.

Your clients can now shop in the following stores for Grocery benefits:

Hy-Vee
Publix
HEB
Central Market
H-Mart
Piggly Wiggly
County Market
Harvest Market
Save A Lot
Woodman’s
Sedano’s
Presidente
Winn-Dixie
Fresco y Más
Harveys Supermarket
Hannaford
Stop & Shop
Food Lion
Giant
Giant Food
Giant Heirloom Market
Giant to Go
Martin’s

These stores are now available for using the Grocery benefit only.

For a complete list of local grocery stores, members can log in to MyBenefits.NationsBenefits.com, select the Flex menu and then select Store Locator. The Store Locator will include the newly added stores starting on 9/14/2023.

Anthem’s NEW RTS Screen on Producer Toolbox – Great Resource!

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Sourced from Anthem broker email communication:

On July 15, 2023, the Producer Toolbox will introduce a new Ready to Sell (RTS) page that allows brokers to view their RTS status for each state they intend to sell Medicare products.

Brokers will easily be able to see if they are licensed, certified, and appointed with each state – as well as complete any outstanding components they may have.

If you have any questions, please reach out to service@cornerstoneseniormarketing.com 

Anthem: Talk Desk Discontinued as of March 20, 2023

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Talk Desk is being discontinued as a tool for recording telephonic scope of appointments and voice signatures. This change comes about due to the CMS implemented requirements of recording all pre-enrollment and post-enrollment calls to prospects and current members.

Additionally, Medicare Voice Signature Services is a new tool that is now available in Producer Toolbox. This tool is only available to use during a face-to-face appointment when the applicant is unable to physically or electronically sign the SOA or enrollment application and does not have a Power of Attorney representative present. The below Quick Reference Guide provides the steps for using the Medicare Voice Signature Service.

Medicare Voice Signature Services Quick Guide – PDF

  • As a reminder, all calls with prospects and current members must be recorded and stored in a HIPAA compliant manner according to the CMS requirements implemented in October 2022. This includes all pre-enrollment calls and post-enrollment calls.
  • By recording all calls, the requirements for recording telephonic scope of appointment and voice signature during enrollment are also fulfilled. It is not necessary to record a telephonic scope of appointment or voice signature separately.
  • Talk Desk, the tool used for recording a telephonic scope of appointment and voice signature, will be discontinued as of March 20, 2023.
  • Historical Talk Desk recordings will continue to be accessible in the Portal.

 

Questions?  Please contact your CSM rep

 

Update on Anthem’s MADP Addendum – Please Read!

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Communication below sent out to all CSM agents as of Thurs. 3/2/23:

Broker Update: Anthem MAPD Addendum Update

Delay as of 3/2/23: The process to review and acknowledge the updated Anthem MAPD Addendum, noted below, is not currently available.  All agents will receive an email communication from Anthem in 2-3 days that the notification is reflecting on their profile and they can complete the required review/acknowledgement per the guidance below.  Our apologies for any inconvenience caused.

__________________________________________________________________

Please note the following action item from Anthem:

In keeping with our requirement to ensure our Third-Party Marketing Organizations (TPMOs) adhere to all applicable laws, regulations, and CMS guidelines, we have updated the Medicare Advantage and Medicare Part D Producer Contract Addendum (MAPD Addendum) language per 2023 CMS Final Rule requirements. TPMO required verbiage has been updated in Section A, Number 4 as well as Section 16: Materials; TPMO Requirements.

Please take a few minutes to read and acknowledge the required document(s) by doing the following:

1. Log into the Producer Toolbox https://brokerportal.anthem.com/apps/ptb/login
2. You will be presented with a dialog box.
3. Click “Sign Forms”.
4. You will be directed to the document(s) that require your acknowledgement/signature.
5. Simply follow the prompts and you’re done.

If you choose to click “cancel” in the dialog box, you will receive the prompt the next time you log in to Producer Toolbox, or once logged in, you can select Account Details > Appointments, and the “Action Required” tab, where you can then sign the required form(s).

Reach out to your Cornerstone Senior Marketing Service Team if you have questions.

Anthem Ohio Network Alert: Christ Hospital Health

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Sourced from Anthem’s Producer Newsletter on 2/9/2023:

February 9, 2023

We’ve worked closely with The Christ Hospital Health Network for several months, but we haven’t reached an agreement to keep them in your clients’ plans.

This means that starting April 1, 2023, your clients may pay more for care they receive from Christ Hospital’s facilities, and May 1, 2023 for care they receive from Christ Hospital’s doctors. This includes care your clients received at the following Christ Hospital facilities:

  • The Christ Hospital
  • The Christ Hospital Medical Center – Liberty Township
  • The Christ Hospital Outpatient Centers
  • The Christ Hospital Urgent Cares
  • The Christ Hospital Surgery Centers
  • The Christ Hospital Outpatient Imaging Centers
  • The Christ Hospital Lab Draw and Pre-Surgical Testing Centers
  • The Christ Hospital Cardiovascular Testing Centers
  • The Christ Hospital Health Network Physical and Occupational Therapy Centers
  • The Christ Hospital Sleep Centers
  • The Christ Hospital Outpatient Clinics
  • The Christ Hospital Wound & Ostomy Care Centers
  • The Christ Hospital Medical Associates (physician practices)

We will be sending a notice to your clients letting them know. Unless we reach an agreement, Christ Hospital won’t be in your plan’s network starting April 1, 2023 for Christ Hospital facilities, and May 1, 2023 for Christ Hospital doctors.

Clients may pay more if they decide to keep seeing a Christ Hospital doctor or receiving care at these facilities
If the client decides to keep seeing this doctor or receiving care at these facilities after April 1, 2023 or seeing this doctor after May 1, 2023, they may pay more or all of the costs for the care. Some plans only cover care from doctors and care facilities in the plan’s network, except in emergencies. Employees can check their plan documents to learn more.

There may be exceptions
A client may be able to stay with Christ Hospital’s doctors and facilities for a limited time if they are in treatment for a serious and complex condition, in the hospital, scheduled for nonelective surgery, pregnant, or terminally ill. Their plan documents include more information about continuity of care.

We will continue to negotiate with Christ Hospital and hope to reach an agreement that keeps them in our plan’s networks.

 

Anthem Dental Expansion Update: Liberty Dental

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Anthem communication as of 10/24/22:

Provider Network Expansion – More dental providers for your Medicare clients!

A network arrangement between our existing commercial participating network of dentists and LIBERTY Dental provides an expanded network for Medicare Advantage dental products effective January 1, 2023. Note: Network expansion will not include NJ and NV.

 

CLICK HERE TO READ FULL ANNOUCEMENT 

Anthem Ohio Medicare Update – Sydney Health and PHE Guidance

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In This Week’s Updates:

  • Sydney Health Member Flier
  • PHE – Guidance and Clarification

 

Sydney Health Member Flier

Medicare Advantage members can access their benefits easily on their mobile device by downloading and registering on the Sydney Health app. The app is free and can be downloaded anytime from the Google Play or Apple App store.

NEW!  A member flier is now available to provide to your Medicare Advantage members! PLEASE CLICK HERE TO DOWNLOAD! 

How can the Sydney Health app help Medicare Advantage members?

  • Provides quick access to their health plan information, including a digital version of their member ID card.
  • Helps members easily track claims and confirm benefit coverage.
  • Members can search and locate in-network doctors.
  • Members can even request a new prescription or refill an existing prescription.

Quick Tip: If a member has already registered online by creating a username and password on the online portal website, there is no need to register again on the Sydney Health app. Members will use the same username and password on the app.

Encourage your Medicare Advantage members to download the Sydney Health app by sharing the member flier with them!

 

 

PHE Guidance and Clarification

According to our CMS Account Management team a few weeks ago, there is no valid SEP in place related to the COVID PHE (last renewed 4/15/2022). We were also informed at that time CMS has been reviewing/investigating carriers releasing information; however, we have no ETA on resolution (i.e. retraction).

Anthem Med Supp Update – Proof of Loss of Group Coverage Required

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Anthem Producer Online News – May 5, 2022

Beginning May 14, 2022, proof of loss of group coverage must be provided for individuals moving from Employer Group medical coverage to a new Med Supp plan. This requirement is found in the Med Supp Guaranteed Issue Guidelines, Situation #2.

Guarantee Issue Situation #2 is described as “having Medicare and an employer group health plan (including retiree or COBRA coverage) or union coverage that pays after Medicare and that plan is ending.” Please review this GI Situation in the guidelines as the member may have additional rights under state law. The Med Supp Guaranteed Issue Guidelines are included with the Med Supp application for your convenience.

Beginning May 14, 2022, when submitting electronic Med Supp enrollment applications for GI Situation #2, you will receive a system prompt, indicating “Loss of Creditable Group Coverage” is required and must be included with the enrollment application submission. If you are submitting a paper application, you or your client must submit the documentation directly to the plan.

Acceptable documentation includes a loss of group coverage letter also known as a “Certificate of Coverage,” or letter from the former plan noting the dates the coverage started and ended. The “Certificate of Coverage” serves as proof of coverage. It is always possible to obtain a replacement copy from the employer or union.

  • If required proof is not submitted with the application, the application cannot be processed until loss of group coverage proof is received.
  • If the loss of group coverage proof is not received within seven calendar days, the application will be closed, and a letter will be mailed to the applicant letting them know the application will be re-opened for processing when it is received by the plan.

The application can be re-opened up to 180 days from the signature date on the application.

Update from Anthem Ohio Regarding Welcome Kits & ID Cards

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Anthem updates on the welcome kits and cards that are being sent out to Ohio clients.

Member Welcome Kit Includes (See link below for more details):

  • Member ID card
  • New member checklist
  • Instructions on how to set up their introduction call

OTC Welcome Kit Includes (See link below for more details):

  • OTC card
  • Important tips on using the OTC card
  • How to use the OTC card guide
  • List of retail stores where members can use their OTC cards

Flex Card:

  • Pre-activated Mastercard that is ready to use when delivered
  • To check the balance of their account members can visit https://mymedicareflexaccount.com or call member services at 1-833-299-5088 and choose the option to hear their current balance.

 

DOWNLOAD ANTHEM GUIDE HERE

 

Lastly, Please be sure to visit Anthem Broker Connection website (using Google Chrome) to register for upcoming trainings https://www.anthembrokerconnection.com/#/home.