Submitting Medicare Enrollment Applications
Contents
1. COVENTRY First Health Part D Health Care 7 from Coventry Health Care October 15 2012 Submitting Medicare Enrollment Applications Please review now and keep a copy handy Starting today Coventry s ready to sell brokers and agents can submit enrollment requests for a January 1 2013 effective date To assure prompt trouble free processing for your clients submitted applications for our Medicare Advantage and First Health Part D plans Coventry s Enrollment Team is pleased to provide this best practice information and reminders for submitting applications smoothly online by fax or through the mail If you have any questions about submitting enrollment applications to Coventry contact your upline marketing organization now If you contract locally to sell Coventry Medicare products please call your local Coventry health plan sales management team e Reminder Agents and brokers may not market or sell Coventry Medicare products or earn commissions if they do not successfully certify annually and receive an Agent Writing Number AWN from Coventry If you have questions about your Ready to Sell status please contact our Medicare Broker Services Department or your upline marketing organization If you are contracted locally please contact your local Coventry sales management team Applications for 2013 AEP elections for January 1 2013 effective enrollment may NOT be dated earlier than October 15 2012 and may NOT be dated later than Dec2. Next Let them know to expect an enrollment verification call from their plan Coventry Health Care This is a CMS requirement as part of the pre enrollment material provided to beneficiaries by brokers and agents Upon receipt of their application within 10 calendar days Coventry will contact them to either by a telephone call or a letter to confirm they understand how the plan works the rules and to answer any questions that they may have Also let them know that Coventry members may be contacted by phone about free services to our members including in home health assessments Easy Options to Submit Enrollment Applications to Coventry Online Fax or Mail ONLINE ENROLLMENT Online enrollment is the fastest way and assures prompt processing of your clients enrollment requests and broker and agent commissions payments e Coventry s web based enrollment system auto assigns an enrollment confirmation number in lieu of an ATN e For enrollments accepted by Coventry s online enrollment system the application date is the date the beneficiary or authorized representative completes the online enrollment Online enrollment MUST be submitted by the beneficiary or the authorized representative e Enrolling Through the Web This brief on demand presentation explains the simple easy steps and exactly what Coventry s selling partners need to know to assist clients with this easy enrollment option PAPER APPLICATIONS Submission by Mail and o
3. than one enrollment request for the same individual with the same effective date in the same reporting period An individual may not be enrolled in more than one MA product or PDP plan at any given time The application date determines the intended enrollment date The last application date received from a beneficiary during the AEP will be the valid enrollment for that beneficiary Be sure to maximize App Tracker to track your submitted business Access the App Tracker tool from the broker portal at http broker cvty com App Tracker User Manual Here s to a GREAT and rewarding 2013 You have our full support Let us know how we can help you for the AEP selling season Be sure that you have carefully reviewed all of this information If you have any questions regarding Enrollment in a Coventry Medicare Advantage or First Health Part D Plan contact your upline marketing organization immediately Agents who are contracted locally to sell Coventry Medicare Advantage plans should contact the local health plan For additional assistance call the Medicare Broker Services Department 1 866 714 9301 Monday Friday 8am 6pm ET or BrokerSupport cvty com This communication is intended for use by Coventry Health Care contracted brokers only and is not intended for distribution to Coventry Health Care members or potential applicants Publication or distribution of this communication to unauthorized recipients without Coventry Health Care approval is p
4. two 2 calendar days Failure to submit a complete dated and signed application on time results in our inability to process the beneficiary s enrollment request promptly which may lead to a cancellation or disenrollment or an agent complaint filed to CMS Agents MAY NOT hold any application for submission e The date of an application is NOT the date the agent or broker submits the application to Coventry e The application date IS the date the broker or agent receives accepts the enrollment request from the beneficiary The CMS required timeframes for enrollment processing begin on this date e Each agent must sign date and include the Coventry Agent Writing Number AWN on every application as soon as you receive it from the beneficiary This includes applications mailed to you Because CMS recognizes acceptance of the enrollment request as the date of receipt by the agent e g in the hands of the agent every application must be submitted to Coventry Enrollment within two 2 calendar days of an Agent s receipt of the application e The 2 calendar day submission requirement directly impacts the application processing for the beneficiary s effective date of coverage e Plan accordingly so that your submission of your clients 2013 enrollment requests for a January 2013 effective date are received by Coventry on time Don t leave your clients in the dark or put yourself at risk for non compliance Always make sure they know What Happens
5. ember 7 2012 e Review with the enrollee all of the fields that appear on the enrollment application and answer all of their questions e It is important that you assist the beneficiary to understand the Medicare Election Periods AND eligibility requirements for enrollment in a Medicare health plan under a CMS Special Election Period e Always provide to the beneficiary a complete pre enrollment kit this is a CMS requirement Use the Enrollment Request form that is included with every kit ordered from Coventry s online sales supply system that you access to on our broker portal e NOTE Coventry pre printed enrollment forms include an Application Tracking Number ATN o The ATN is critical to Coventry s prompt processing of your clients enrollment requests and your commission payments Submitting an enrollment form to Coventry that does not have an ATN may jeopardize processing o Do not use or submit a copy of a paper application because it will not have a unique ATN A complete application is the first step in the enrollment process When an agent is assisting a member to complete their application the agent is responsible for answering all of the beneficiary s questions and assuring all information that the enrollment form requires is provided and complete Applications that are not completed thoroughly and accurately or are not submitted in their entirety cause delays in processing of the enrollment and an inconvenience to the new memb
6. ers ONE application per beneficiary Each application MUST include e The beneficiary s complete name as it appears on their Medicare card e Complete date of birth e Medicare Claim Number HICN the complete HICN is required on the application in the section for Medicare Insurance Information Verify this number against the number printed on the beneficiary s Medicare card e Proof of Medicare Part A and or B entitlement e The beneficiary s physical Street Address Post Office Box is not acceptable e Member effective date without it delay in processing and potentially a delay in payment of commission e Valid Plan Selection make sure the Plan Selection is clearly marked and that it is exactly what the beneficiary has chosen and agrees to e Confirmed designated telephone number for the beneficiary to be contacted by Coventry e Method of Payment e Signature s and Date e Signed complete Scope of Appointment Form VERY IMPORTANT Scope of Appointment SoA All agents and brokers MUST use either the CMS Model SoA form or the CMS approved Coventry non model form and MUST attach a copy of the signed SoA form to any application received from a personal individual face to face meeting BEFORE submitting the application to Coventry Coventry non Model form available in English and in Spanish on the Broker Portal at http broker cvty com Scope of Appointment Form Enrollment forms MUST be submitted to Coventry within
7. r Fax Coventry Medicare Advantage Local Health Plan Mailing Addresses and Fax Numbers Medicare Advantage Enrollment Fax Cover Sheet First Health Part D PDP Enrollment Fax Cover Sheet e Coventry Medicare health plans each have a unique Mail To address telephone and fax number for submitting enrollment applications Mail or fax according to the plan specific information printed on the Enrollment Request form e Do not submit applications to the Broker Services Department e For Medicare Advantage enrollment questions be sure to contact your local health plan e Donot Overnight Mail any enrollment applications to a PO Box You must use the street address indicated on the enrollment form e Plan ahead and submit apps as soon as possible to ensure receipt at Coventry within two calendar days and to accommodate potential high fax volume e It s best to fax applications one at a time e Include a cover sheet with every fax transmission Include your AWN name email address and telephone number Also indicate the beneficiary s name e Best practice tip To assure the Plan Selection information is readable and clear in the received fax transmission in addition to having the plan selection checked off on the app also circle underline the selection e Keep a copy of the confirmation of the fax transmission for your records as proof of submission date and time Trumping Rule Multiple enrollment transactions occur when CMS receives more
8. rohibited
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