SirLurkAlot
Expert
- 59
First, I have been in the business 15+ years and have NEVER had any complaints or violations alleged against me because I am diligent about being thorough and ALWAYS put client interests first.
I am very upset at what has transpired and can't believe it is a CMS violation so I am seeking other opinions.
I faxed a Healthspring MAPD application taken on 11/22/14 and it was received by the company on 11/23. On 12/2, I received a notice of a timeliness violation stating that I committed a violation because the application was "received more than 3 days after signature date."
I immediately looked into the situation and determined I had inadvertently written 11/12 instead of 11/22 in the agent area of the application for the date the application was received. Both the Scope & application dates signed by the client were 11/22/14- I had just mis-wrote my date.
I responded to Healthspring on 12/3 with the following:
"In response to the accompanying email, I attest that the application for (MEMBER) was executed on November 22, 2014 as indicated by her signature date on both the application and Scope of Appointment, which was required due to a request to discuss Healthspring. I inadvertently listed 11-12-14 in the receipt date in the agent section but all other dates reflect the correct 11-22-14 date which would make the application submission timely.
(MEMBER) is a long time client of mine and our meetings are always on Saturdays so her children can attend. Two of her children in attendance were XXX (Phone #) and XXX (Phone #) that will also attest to the 11-22-14 meeting date.
I have included a copy of the allegation email & copies of my calendar pages.
Please let me know if you have any questions or need anything additional.
Thanks!"
Today, I received notice that it is indeed a violation, now on my record, I have to do something, submit remediation forms, etc. Interestingly, the letter acts like the sales manager, who signed the letter, had discussed this with me but she hasn't. I got the original violation, responded and assumed "No problem" until today. Awww, the old ASSUMED.
So, Ye' Old Wise Ones of the forum, is this truly a CMS violation? Do I have any re-course to get this reversed\removed\etc.
Thanks in advance!
I am very upset at what has transpired and can't believe it is a CMS violation so I am seeking other opinions.
I faxed a Healthspring MAPD application taken on 11/22/14 and it was received by the company on 11/23. On 12/2, I received a notice of a timeliness violation stating that I committed a violation because the application was "received more than 3 days after signature date."
I immediately looked into the situation and determined I had inadvertently written 11/12 instead of 11/22 in the agent area of the application for the date the application was received. Both the Scope & application dates signed by the client were 11/22/14- I had just mis-wrote my date.
I responded to Healthspring on 12/3 with the following:
"In response to the accompanying email, I attest that the application for (MEMBER) was executed on November 22, 2014 as indicated by her signature date on both the application and Scope of Appointment, which was required due to a request to discuss Healthspring. I inadvertently listed 11-12-14 in the receipt date in the agent section but all other dates reflect the correct 11-22-14 date which would make the application submission timely.
(MEMBER) is a long time client of mine and our meetings are always on Saturdays so her children can attend. Two of her children in attendance were XXX (Phone #) and XXX (Phone #) that will also attest to the 11-22-14 meeting date.
I have included a copy of the allegation email & copies of my calendar pages.
Please let me know if you have any questions or need anything additional.
Thanks!"
Today, I received notice that it is indeed a violation, now on my record, I have to do something, submit remediation forms, etc. Interestingly, the letter acts like the sales manager, who signed the letter, had discussed this with me but she hasn't. I got the original violation, responded and assumed "No problem" until today. Awww, the old ASSUMED.
So, Ye' Old Wise Ones of the forum, is this truly a CMS violation? Do I have any re-course to get this reversed\removed\etc.
Thanks in advance!
