This is my first year in Medicare and it’s exhausting already. Every single person i call in my client list for their annual review has so many questions about bills they’ve received, ambulance bills “You told me it would be $250 why am I being billed for $1700”, “my prescriptions aren’t the price you said they would be”, “I got this bill from medicare”, on and on and on. Then I ask them to get the bill and then they can never find it either so there’s no way of knowing anything what’s actually going on. I was on the phone yesterday for 5 hours just answering questions like these. I dont know if this is normal for your yearly reviews, and if not I don't know what I’m doing wrong, but this sucks!
What am I doing wrong
- Thread starter jack3454
- Start date
How are initially finding these people? That may be the issue.
Also, a lot of times they get a bill that’s not actually a bill. They see big numbers and want to complain before it hits insurance.
With medications, never assume retail price when a tier is a %. That might help.
Also, a lot of times they get a bill that’s not actually a bill. They see big numbers and want to complain before it hits insurance.
With medications, never assume retail price when a tier is a %. That might help.
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You aren't selling it correctly. The goal is that you get no questions during AEP that aren't pertaining to next years plan.
So manage the clients better during Medicare 101. "Please don't hesitate to reach out as if you get any bills or notices that don't look right. I am not copied on those and its important we jump on it if there is a problem because if you wait a couple of months, its not always fixable."
You will learn to tell people certain things during Medicare 101, with a goal of getting zero calls that start with "you didn't tell me that". One of my favorites is to tell people that their drugs don't apply to the Part D deductible, but if the doctor puts you on something fancy and expensive, the pharmacy is going to want at least $545 the first time you fill the prescription. They never remember and I always get the call mid-year. And when I say "did the doctor put you on something fancy and expensive", it clicks and they remember.
I also make sure they understand that the Medicare EOB and Plan G EOB will say "not covered" for the Part B deductible. Instead of "applies to deductible", so don't panic. As long as you aren't paying more that $240, we are fine.
Finally, you need to check in with your clients quarterly. Email is fine. But it also will bring up these questions, so you aren't getting beat up in 4th quarter.
HANG IN THERE
So manage the clients better during Medicare 101. "Please don't hesitate to reach out as if you get any bills or notices that don't look right. I am not copied on those and its important we jump on it if there is a problem because if you wait a couple of months, its not always fixable."
You will learn to tell people certain things during Medicare 101, with a goal of getting zero calls that start with "you didn't tell me that". One of my favorites is to tell people that their drugs don't apply to the Part D deductible, but if the doctor puts you on something fancy and expensive, the pharmacy is going to want at least $545 the first time you fill the prescription. They never remember and I always get the call mid-year. And when I say "did the doctor put you on something fancy and expensive", it clicks and they remember.
I also make sure they understand that the Medicare EOB and Plan G EOB will say "not covered" for the Part B deductible. Instead of "applies to deductible", so don't panic. As long as you aren't paying more that $240, we are fine.
Finally, you need to check in with your clients quarterly. Email is fine. But it also will bring up these questions, so you aren't getting beat up in 4th quarter.
HANG IN THERE
- Thread starter
- #4
Direct mail, referrals mostly.
So should I tell them to wait until they see something that says “this is a bill”? Or how do you let them know?
For the prescription thats a percentage, what do you tell them?
Yes, the first thing I ask them is, does it say “pay this amount” or this is a bill. Usually it actually says the opposite.
when it’s a % I say, once you meet your deductible, you will pay this %. I don’t guess that for them. Medicare is rarely correct on retail.
- Thread starter
- #6
Thank you for the advice, I can definitely implement these things into my process and hope they will help relieve some of the issues Im having!!
- Thread starter
- #7
Great, thank you!
