I think were on the cusp of chaos in mapd networks as insurers and hospitals fight

[Newby]

I don't know. I've had UHC pay out over $18K for a client who showed up at an out-of-network hospital. But I guess they had to pay it because it was an emergency. He ended up passing and they charged back my $603 trued up commission. I thought that was wrong, but I didn't dispute it, on the grounds I shouldn't have moved him off his Med supp in the first place. UHC eventually paid, but everyone in that hospital kept reminding him and his loved ones, that he's not in network! To add that stress on top of losing a loved one, only for the bill to eventually cleared up in the end, is not worth leaving Original Medicare IMHO!

I was an emergancy and I was in network.

 

[sshafran]

I was an emergancy and I was in network.

Maybe they were mad that you didn't write enough med supps that year with them....

Run some more leads next time and you'll be good.

 

[Newby]

Maybe they were mad that you didn't write enough med supps that year with them....

Run some more leads next time and you'll be good.

Could be as I wrote exactly zero.

 

[MedicareAgent]

UHC PPO has required a PCP for over a decade, at least now. Well, in FL they have. That’s nothing new. Humana and Aetna don’t.

I should have specified that it is now nationwide that they will require a pcp, yes, Florida always has needed that on applications.

 

[sshafran]

I should have specified that it is now nationwide that they will require a pcp, yes, Florida always has needed that on applications.

If an agent doesn't write in a PCP what happens? Auto-assign?

They don't withhold comp, do they?

I don't think I knew that was required and often on Sunfire just skip it on PPOs.

 

[LostDollar]

Would the responses here differ between under 65 health coverage and MAPD health coverage?

 

[Chazm]

If an agent doesn't write in a PCP what happens? Auto-assign?

They don't withhold comp, do they?

I don't think I knew that was required and often on Sunfire just skip it on PPOs.

They’ll auto assign one. They put the doctors name on the card like an HMO

 

[Special Agent]

I’m reading a ton of story’s nationwide of standoffs between big hospital systems and Mapd insurers fighting over rate increases . There’s no more “ it’s all bs they always come to an agreement “ Everyone digging their heels in and the patients in the crossfire . Hell i sound like Somarco . lol . But I’ll be offering more med supps to people that can afford it .

I don't know. I've had UHC pay out over $18K for a client who showed up at an out-of-network hospital. But I guess they had to pay it because it was an emergency. He ended up passing and they charged back my $603 trued up commission. I thought that was wrong, but I didn't dispute it, on the grounds I shouldn't have moved him off his Med supp in the first place. UHC eventually paid, but everyone in that hospital kept reminding him and his loved ones, that he's not in network! To add that stress on top of losing a loved one, only for the bill to eventually cleared up in the end, is not worth leaving Original Medicare IMHO!

They’ll auto assign one. They put the doctors name on the card like an HMO

haven't used this in a minute but there is a dummy code that can used and you the put "medicare pcp " in pcp name field that would generate a blank pcp name on id card ( not always but usually)If you know anybody that worked at UHC telesales they could give you that dummy code

 

[DonP]

haven't used this in a minute but there is a dummy code that can used and you the put "medicare pcp " in pcp name field that would generate a blank pcp name on id card ( not always but usually)If you know anybody that worked at UHC telesales they could give you that d

Correct there’s a dummy code . Producer help desk should give it to you . You can use it on hmo or ppo apps . problem is it still auto assigns an arbitrary name and the client might call you

 

[axeman462]

UHC PPO has required a PCP for over a decade, at least now. Well, in FL they have. That’s nothing new. Humana and Aetna don’t.

UHC does not on the PPOs, haven't had a PCP on a PPO app in years