Blocking a MAPD disenrollment to retain clients- is it legal??

[AgentGeneral]

Yes- that is true. But the question is- is it legal (by CMS standards) to contact the client in the process of disenrolling for the sole purpose of retaining the client (no matter how crappy the new plan is for the client)?

Not specifically for that no. It is legal to call and check in with your current client, have a discussion on whether they are happy with their plan, and to remind them that you're only a phone call away with questions and concerns. It's all in how you word it. IF while youre doing that, you happen to find out they were "duped" you should be able to navigate a way to fix that situation.

I can't count the times I've been called by them just to remind them that, "NO there are not food cards available for you in our county, you are not on medicaid, nor do you have one of the SSBCI conditions....."

With that said, the few I have had to save, they have thanked me for helping them fix that situation. It does help solidify the relationship. Dont shy away from it. If you see or hear a "dupe" get on it and help your client. I have let a couple go intentionally, since I don't have time to repeatedly warn that full sets of implants are not covered.

Also, on the BCBS issues I did get to the bottom of it and getting those fixed. Its also fixable when a client calls in to add dental vision or something and another agent magically gets an AOR form signed. Thats fixable, but since I hate wasting my time, I will still steer clear of the Big Blue.

 

[wehotex]

No way that tab is correct. I clicked on future terms and it shows 81 people. They list all the people that I have on Careplus. Maybe Careplus is the issue.

 

[wehotex]

Did you REALLY lose 81 in 1 month?

 

[DonP]

No way that tab is correct. I clicked on future terms and it shows 81 people. They list all the people that I have on Careplus. Maybe Careplus is the issue.

Its correct . But todays the first and it’s whacky as the new months reset