UHC Telephonice Enrollment Tip: If consumer has no access to internet

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What if the consumer does not have access to the internet? Scope of Appointment and Enrollment forms can be sent via mail for signature. In the event that using mail does not meet the desired effective date, agents may use the following process for consumers without internet access:

1. Following your needs analysis conversation, direct the consumer to call 855-572-3837. Inform your consumer that the representative will repeat some of the questions in order to meet all compliance requirements.

2. Email agentoversightadmin@uhc.com to indicate your consumer was unable to electronically sign documents and completed the application telephonically instead. Include name of prospect, date of presentation/referral to telesales, agent name, and writing ID. This will help ensure your commission payment and Agent of Record status.

UHC Renew Active – Update through COVID-19

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In rapid response to gyms temporary closing due to COVID-19, Renew Active has enhanced its offering to include Fitbit Premium, as well as a “Staycation” feature with our cognitive partner, AARP Staying Sharp.

Fitbit Premium is now available to take advantage of for all members with Renew Active when they join the Fitbit Community for Renew Active (screenshot below). Fitbit Premium offers premium content and thousands of workout videos for all levels and intensity. The premium content and workout videos include;

  • A vast selection of yoga, weight training, low impact and equipment optional workout videos
  • Guided programs
  • Advanced sleep tools
  • Personalized insights
  • Mindfulness sessions 

Please note a Fitbit device is not required to access these workout videos.

In addition to Fitbit Premium, AARP Staying Sharp, our cognitive partner, launched a Staycation tile on their website. Here Renew Active members can access various content, including 17 quick in-home workout videos for members to stay active while in their home.

Additional information:

  • Member access: For access to the Fitbit Community and/or AARP Staying Sharp, Renew Active members can visit the Health and Wellness tab in their portal and begin the process of either joining the Fitbit group or registering on AARP Staying Sharp.
  • Renew Active Fitbit Community: Digital community where members can engage in health & wellness discussions and participate in step challenges with other Renew Active members
  • AARP Staying Sharp: Members can engage in a brain-health assessment, articles, recipes and even several short exercise videos. The videos vary between stretching, showcasing different types of yoga poses and strength exercises.
  • Many of our gym partners are offering digital classes and workouts to members during the time of their closure.

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Aetna – COVID-19 Update

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Aetna:  March 26, 2020:  Steps we’re taking to keep members safe:

  • To help prevent the spread of the coronavirus, known as COVID-19, we are cancelling all in person group member meetings and sales events at all venues, including those at retail locations. 
  • Sales events: If you have a filed a sales event with Aetna, we have canceled your event. CMS requirements for canceled events still apply. Please contact your Broker Manager if you have any questions about CMS requirements for cancellations.  
  • Member meetings: Please note that we will contact all members who RSVP’d for a meeting, by phone or email, to let them know about the cancellation. 


IMPORTANT: We highly recommend avoiding face-to-face contact with your clients. Instead of meeting with them in person, we encourage you to use our remote-selling tools (e-kits and RATE) to engage your clients electronically. 

Read the full update:

COVID-19 update_broker communication (March 19) FINAL

UHC’s New Base Contract Requires Agent & Agencies Signature- Please Read!

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UHC’s New Base Contract Requiring Agent/Agency Signature

March 25, 2020

Beginning April 2, 2020, and continuing through May, UnitedHealthcare will begin sending new base contracts in an email from UnitedHealthcare Medicare Solutions Contracting. The new consolidated contract incorporates all contract changes incorporated in recent years by amendments, and contains minor changes to clarify terms.

Please look for an email from UnitedHealthcare Medicare Solutions Contracting and review and sign your new contract using DocuSign® within 30 days of receipt. Once you have completed the re-contracting process you will receive a confirmation email.

 

Remember to check your spam folder throughout April and May if you do not see an email with the new contract.

For more information and assistance with reviewing and signing the new contract please review the attached Job Aid and FAQ

MMO Broker Update – Telehealth/Telemedicine Coverage

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Important Clarifications on Telehealth (Telemedicine) Coverage
 
Date: March 24, 2020
Category: News
Applies to: All

In efforts to help slow the spread of the coronavirus disease known as COVID-19, health professionals and their patients may turn more frequently to the use of telehealth (telemedicine) visits. Please review the summaries below: to better understand the coverage for these services.

Telehealth (telemedicine) visits (covered by all plans)

  • Telehealth (telemedicine) visits are primarily scheduled visits between patients and healthcare providers with an established relationship, and may be handled by computer, tablet or smartphone.
  • Telehealth (telemedicine) visits are for patients needing routine care for chronic or general health conditions. They are covered just like any other medically necessary office visit.
  • They are billed with office visit codes; modifiers are not required.
  • Behavioral health visits are included.

On-demand virtual visits (covered by most plans)

  • On-demand virtual visits are a subset of telehealth (telemedicine). These types of visits typically include 24/7 virtual access to licensed healthcare professionals with whom the patients do not have an established relationship.
  • They are similar to visits to an urgent care facility and are typically needed due to an acute health issue.
  • Visits are typically covered like primary care provider visits unless otherwise specified.
  • Behavioral health visits are not covered as on-demand virtual visits.
  • Examples of plan-specific covered on-demand virtual visit providers include the Cleveland Clinic’s Express Care online services and Teladoc.

If you have any questions about telehealth (telemedicine) benefits, please contact your Cornerstone Senior Marketing Representative

 

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

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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

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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)

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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

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

LEAN_User_Guide

Wellcare COVID-19 Updates and Talking Points

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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.