Trying to understand the Medicare / MA sales process

[Todd King]

I work with independent physician groups and they're interested in evaluating in more detail whether or not and how they'd play a role in the MA marketing process. The information would just be shared in a conclusion form of "Here is how you could (or couldn't) fit into the general MA process in conjunction with brokers" and how the process works overall.

From my experience the best thing that physicians and staff can do is to do the thing they do best (medicine) and stay the hell out of our way. I've seen Dr.'s offices mess up more than they have ever helped when it comes to the process of selling/enrolling a client.

 

[vic120]

From my experience the best thing that physicians and staff can do is to do the thing they do best (medicine) and stay the hell out of our way. I've seen Dr.'s offices mess up more than they have ever helped when it comes to the process of selling/enrolling a client.

So Much this, I remember 2 years ago I was able to save a woman well over $100 per month with a new era plan, I got her approved and she really was struggling before to make payment on her old Mutual plan.I mean like not having enough for groceries, She had health issues (I don't remember what now) I could only get her approved with a new era

The day after she was approved she called me flipping saying Doc office manager told she if she takes that plan she cannot continue to go there as they are not in the network.

I even did3-wayy call with doc office and tried to explian but the gIrl kept saying I never heard of them we are not going to take this insurance, We are not in network period

Damn Shame

 

[XpressInsurance]

From my experience the best thing that physicians and staff can do is to do the thing they do best (medicine) and stay the hell out of our way. I've seen Dr.'s offices mess up more than they have ever helped when it comes to the process of selling/enrolling a client.

I would agree with Todd & Vic. We have too many billing clerks at doctors offices & hospitals that give bad insurance advice. Few years ago I had a prospect that had a lot of health problems, her family member who was worked in the billing office told her that she needed AARP MAPD. She told her she would never get a bill if went to the hospital or doctor. Tried & tried to set that woman straight but she was convinced her family member was right.

 

[somarco]

LauraC83, what's in this for the docs? Why push a specific product? What is the end game?

 

[LauraC83]

Like a lot of health systems partner with a particular plan, some independent groups are looking into whether thats an option that would make sense for them

 

[somarco]

That type of arrangement certainly restricts options for patients, or at least gives the impression of limiting access.

What kind of financial incentive in it for the docs?

 

[Fisher]

What kind of financial incentive in it for the docs?

Same thing I asked yesterday. Sounds like steering, a bit.

 

[somarco]

Same thing I asked yesterday. Sounds like steering, a bit.

Steerage happens with managed care, but that is more from the patient side. Your copay with Dr Kildare is $20 because he is in network; for Dr Casey you will be $40 since he is non-par.

Carriers and MCO's impact patient steerage.

But when the provider is the pimp it takes on a different perspective.

This is the 3rd time I have asked what is the juice to the doc and still don't have an answer. Somehow I don't think we will know.

Either C83 doesn't know or doesn't want to talk about it.

 

[LauraC83]

Don't know, this is very exploratory and the answer very much may be there is nothing that makes sense here

 

[somarco]

the answer very much may be there is nothing that makes sense here

Sure sounds like it