Thank you for your continued participation and cooperation. Additionally, you must include the following disclaimer on all advertisements and invitations for your event: For accommodation of persons with special needs at sales meetings call .. For virtual events, use Aetna Medicare seminar reporting template, and in the address column provide the URL, call-in number and meeting codes for the event. Submit the event cancellation to all carriers involved or your upline, Be present, or have a plan representative present, on site at the original start time to let potential attendees know about the cancellation and provide them with plan information (unless the cancellation is due to inclement weather), Remain, or have the plan representative remain, on site at least 15 minutes after the original start time, Tell potential attendees about the canceled event the same way you let them know about it (If you cannot, you must provide proof substantiating that to all carriers involved). Ascend is a fast, easy, and compliant way for agents to submit agent-assisted electronic enrollments. While just putting out a flyer with your sales seminar or workshops information on it seems nice, its unacceptable. It may take up to 15 calendar days to receive a decision (14 calendar days for UnitedHealthcare Medicare Advantage plans). {' (P0=X8%o9" :bt!.}C]8Bn h)?]m/ZNHi1rtt=@lN: yY\$di+>m9kj1lu).Sbog?Q.Cn[:~ !2 }`!msT6AvrclV/ccus|#2iW8e|eODF8RnW@gI53u2yPY6j=M7^vk?g).Ky>NXQd6jZ[ii3eQe,?\7_VwW;B"y?{{>{~0 )Im To ensure accurate data entry, you should repeat the Medicare ID back to the beneficiary. Note: Any event not advertised as educational can be viewed as a marketing event and should be registered as one. There are two types of sales events: formal and informal. Cigna employed agents must contact their manager. 0 They fit here as well. This is a summary of the Prior Authorization and Notification Program and is not meant to be comprehensive. What type of events need reported: Which of the following is not a Wellcare quality driver? Returns the string ID of the notification button the user clicked. Upon completion of the event, break down your table and chairs, and notify the Management Team Member that the event is over and that you are leaving Kindly thank them for having you there Don'ts Do not conduct health screenings or other like activities that could give the impression of "cherry picking" Inherits from Event. But you could schedule an appointment to take place Oct. 1 or later on the same inbound call. Reporting template and e-mail address: or What is allowed at seminars for the 2023 Annual Enrollment Period? Prior to the Medicare Annual Election Period (AEP), you may have questions surrounding what you can and cannot do to market plans before October 1, which is the start of the AEP marketing period. website belongs to an official government organization in the United States. On the date the preauthorized or approved service was delivered, the member was not covered by UnitedHealthcare, and the care provider could have verified the member's eligibility status by using UnitedHealthcare's automated eligibility verification system (VETTS). You can follow these guidelines to stay compliant: 334 0 obj <> endobj Full instructionsfor the Original Medicare, also known as Fee for Service (FFS), expedited determination process are available in Section 260, of Chapter 30 of the CMS Claims Processing Manual, available below in "Downloads". Wellcare Flashcards | Quizlet .gov 0 Identify the INCORRECT statement regarding the plan consolidation. Answer the following questions using the appropriate counting technique, which may be either arrangements with repetition, permutations, or combinations. Check out our streamlined version of the Medicare Advantage & Part D Communication Requirements for sales events below. endstream endobj 699 0 obj <>stream FALSE Ascend is a fast, easy, and compliant way for agents to submit agent-assisted electronic enrollments. Local sales support at the health plan level can help you: Wellcare offers a wide variety of Medicare products consolidated under a new Wellcare brand. A coverage determination (exception) is a decision about whether a drug prescribed for you will be covered by us and the amount you'll need to pay, if any. Enable JavaScript to view data. Contact your local Aetna Medicare broker manager to get the appropriate Seminar Reporting Template, templates vary slightly by market. All standalone PDP formularies have a ___-tier structure for 2022. A federal government website managed and paid for by the U.S. Centers for Medicare & Medicaid Services. If youre a licensed agent within an Aetna local market, submit your events directly to your market. Reporting template and e-mail address: You cannot discuss plan options for the next plan year until Oct. 1. WELLCARE CENTENE Flashcards | Quizlet website belongs to an official government organization in the United States. ), Give away promotional items that include plan name, logo, toll-free number, and/or carrier website, Use contact information provided by attendees for raffles or drawings for any other purpose, Provide refreshments or light snacks (e.g., coffee, soda, fruit, crackers), Hand out objective educational materials on Medicare Advantage, Part D, and other Medicare programs, Offer or subsidize meals or a combination of foods and beverages that could make it seem like youre offering meals, Distribute Star Ratings information, Summary of Benefits, Pre-Enrollment Checklist, and the Multi-Language Insert with any enrollment form, Require attendees to fill out a Scope of Appointment form or enrollment forms, Collect lead cards and business reply cards, Use the necessary TPMO disclaimer on printed marketing materials, Freely give out your business card to any attendee, Arrange follow-up appointments & collect Scope of Appointment forms for future appointments, Call attendees who attended a sales event if they gave express permission at the event for a follow-up call (you must have documented permission to contact), Within 48 hours of its originally scheduled date and time for any reason (including zero attendance), At least 48 hours in advance of its originally scheduled date and time. Need access to the UnitedHealthcare Provider Portal? Full instructions for the Medicare health plan expedited determination process, also known as the Medicare Advantage (MA)fast track appeals process, are available in the Parts C & D Enrollee Grievances, Organization/Coverage Determinations, and Appeals Guidance, inSection 100, available below in "Downloads. %PDF-1.5 % Which of the following statements about Scope of Appointment (SOA) is FALSE? Useful member resources (e.g. Agents do not need to record conversations when meeting in person. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options. hb```VfVAd`a`b MXEMX9`0`p85WmJX %/51Vbyaw "/e,:"t+~@)Pl'I,=R 0vE' HQQLw0Ut4wt0 ;dCDB*`AW$Ag@>f0j iQ?4 $q+70wP|p!24rB[Fm[?0 20 6oP If the physician has obtained prior authorization or advance notification, the initial day of the inpatient admission will be paid, unless: If advance notification is obtained but is not made by the facility in a timely manner, payment reductions will be limited to hospital room and board charges, when applicable. stay compliant when holding a Medicare educational event, strategies to grow your insurance business, Rules for Hosting a Compliant Medicare Educational Event, What Not to Say During Medicare Educational and Sales Events, Notify attendees of when your sales event begins, if your event follows directly after an educational event, and give them the opportunity to leave, Let beneficiaries approach you first at informal events, Offer health screenings or similar activities that could seem like, or be used for, cherry picking, Use sign-in sheets that clearly indicate providing contact information is, Name all products and plan types youll cover before starting, Compare one carriers plan to other carriers plans by name without getting written consent from all carriers involved in the comparison or without having studies or statistical data to back up comparisons (Comparisons must be factually based and cant be misleading), Use only carrier- and CMS-approved presentations and talking points, Discuss or cross-sell non-health care related products (e.g., annuities, life insurance), Distribute giveaways with your contact information on it, Use absolute or qualified superlatives (e.g., This is the best plan! P.O. If you fail to notify WellCare of admissions or observation stays, the claim may be denied. Wellcare has streamlined standalone PDP offerings from six plans to ___ in all 34 regions across all 50 states and D.C. For the 2022 plan year, which health plans will be consolidated into the Wellcare Medicare brand: Health Net, Fidelis Care, AllWell, 'Ohana, Trillium Advantage, WellCare. Reporting often involves submitting an event information form to a sales manager or representative through email or using an online reporting tool. 357 0 obj <>/Filter/FlateDecode/ID[<00965AF0D543484FAE7F73A0B78C95D6>]/Index[334 50]/Info 333 0 R/Length 112/Prev 159370/Root 335 0 R/Size 384/Type/XRef/W[1 3 1]>>stream Its never been easier to shout your message from the proverbial rooftop. All formal Sales events must be reported at least 21 days ahead of the event date. California and Washington providers, hospitals and other acute inpatient facilities are subject to the admission notification requirements described in the UnitedHealthcare Administrative Guide. Heres how you know. Plans must notify all concerned parties upon completion of the investigation as expeditiously as the enrollee's health condition requires, but no later than 30 days after the grievance is received. Explain your reasoning. Thank you for your continued participation and cooperation. lock notification of events must be received by wellcare If prior authorization or advance notification is needed for the requested elective inpatient procedure, it is the physician's responsibility to obtain the relevant approval. Shortly before she started at Ritter, Roxanne earned a Bachelor of Arts degree in English with a professional writing concentration from Elizabethtown College. While events are often a great way to generate leads, holding Medicare educational events during the COVID pandemic is a legal and ethical grey area. hbbd```b``dd&v$=G\A@D0 C> A grievance request, or any evidence concerning a grievance, must be filed orally or in writing no later than _____ calendar days from the date of the event or the date the member is made aware of the issue. Which stage of coverage is referred to as the "donut hole" as the member is paying the most for drug coverage: Noting the correct enrollment period on enrollment applications helps in preventing delayed enrollment processing: Which of the following actions are you required to do when contacted regarding an allegation of noncompliant activity?