Any time an application gets flagged during the submission process, it’s a delay on your clients’ coverage and your commission. What if we told you we can help you avoid stalled applications?
Throughout the year, agents and agencies submit hundreds of enrollment applications. To help you ensure your submissions pass through the system cleanly, we’ve put together some tips for completing flawless applications.
Move Online
Before we get into the nitty-gritty, we’d like to mention an overarching suggestion — move your applications online. Paper applications grow more obsolete as carriers perfect their online forms, FMOs (like us!) create useful tools, and more and more people over 65 use the internet. In fact, about 53 percent of adults apply for Social Security online, which has increased roughly 10 to 12 percent over the last 10 years.
Hint: Ritter’s tools make it easier.
1. Prepare Thoroughly
Before you begin an application, make sure you have all the necessary client details gathered, like full name, date of birth, and Medicare Beneficiary Identifier (MBI), all in one place. If you must navigate away from an online application or get up and grab something you forgot, you increase the risk of losing your spot or making a mistake.
Prepare Online with MedicareCENTER
Put in place good processes for collecting the necessary data for an application, like utilizing a good customer relationship management (CRM) system. Integrity’s CRM, MedicareCENTER makes it easy to store and access client information as well as both inbound and outbound sales calls.
You can gain access to Integrity’s full suite of sales techolony solutions by completing one sign up with MedicareCENTER!
2. Write Neatly and Legibly
If you’re completing a paper app, use a pen with blue or black ink and do your best to keep your handwriting easy to read. If there’s any room for interpretation, the carrier will end up circling back to confirm what’s meant, which delays the process.
If you can’t read the application, it’s likely we can’t either. It never hurts to review the application with the client to ensure its accuracy before moving it through the submission process.
Keep It Neat Online
It may be silly to state the obvious, but if you submit online applications, no one has to worry about reading your handwriting!
3. Keep in Compliance with SOA Rules
CMS’ rules on Scopes of Appointment (SOAs) dictate that agents must complete an SOA 48 hours before making an appointment with a beneficiary. Exceptions to this rule include when a beneficiary is four days or less from the end of a valid enrollment period (e.g., Annual Enrollment Period, Open Enrollment Period, Special Enrollment Period, Initial Coverage Election Period) or unscheduled in-person meetings (walk-ins) initiated by the beneficiary.
The SOA is also only valid for 12 months, and you will need to get a new one if the original expired. We recommend tracking the start and stop date within your CRM.
Please note, you cannot complete SOAs for AEP before October 1.
On the SOA itself, make sure that at least one of the selected types of contracts to be discussed on the SOA matches the plan that’s chosen on the application. Additionally, make sure that each field is filled out in its entirety and is legible, if you’re filling out a paper SOA. If during your meeting, you and the client decide you’d like to discuss additional plan types, simply fill out another SOA.
The SOA is a good point of reference for agents to easily access clients’ contact information in the future. Even if certain fields are “optional” on the SOA, it’s likely in your best interest to make sure everything is filled out anyways!
SOAs must be kept on file for 10 years per CMS rules, regardless of if a sale occurred or not. Keep in mind, even as CMS rules change, some carriers may maintain their current policies. You’re still responsible for following the procedures of the carriers you represent.
Even if certain fields are “optional” on the SOA, it’s likely in your best interest to make sure everything is filled out anyways!
4. Provide Details Where Required
If an applicant answers “yes” to any health question that requires additional information, be sure it’s provided on the application. Additionally, if the SEP requires any extra information (e.g., a chosen PCP, Medicaid, PDP, or Extra Help info), it must also be on the application.
Store Details in Your Client’s Profile
On top of basic information, you can store a myriad of client details in MedicareCENTER — conditions, providers, preferred pharmacies, and prescriptions.
When you go to fill out an application, you’ll have all the details you need stored in one place — your client’s profile!
5. Select a PCP When Necessary
If an applicant would like a carrier to auto-assign a primary care physician (PCP), be sure to note that in the appropriate field. Some plans require a PCP selection, so leaving this field blank could hold up an application’s approval.
Typically, applications for HMO plans require the applicant to specify an in-network PCP. Check to make sure an in-network PCP is on any application for an HMO plan to prevent roadblocks in the enrollment process.
As with most application information, it’s always better to have more information rather than not enough. Therefore, if your client can list a PCP, request they do so regardless of the requirement.
Copy & Paste from Your Clients’ Records
As mentioned above, MedicareCENTER can organize much of your clients’ information. It can also enable prefill capabilites into an application. Now, everything might not prefill, so don’t forget the power of copy and paste. Pull up one web browser window with your client’s profile. Pull up another with the application. Now you can easily copy and paste information from your client’s file into the application without having to retype everything (and without increasing the chances of mistakes).
To start, highlight the info by clicking at the start of it and dragging your mouse to the end of it. Next, either use the shortcut ctrl + c on your keyboard to copy or right-click on your mouse and select Copy. Then, click where you need to paste it and either use the shortcut ctrl + v to paste or right click with your mouse and select Paste. Alternatively, leave it blank and request that the client fill in this information after you send the prefilled app.
6. Match the Attestation with the Election Period
The selected period in the attestation of eligibility section needs to align with the selection of IEP, AEP, or SEP in the agent/office use section of the application.
If the election period requires a date (such as the date a client is losing coverage), make sure it’s present and accurate. Additionally, if the SEP requires any extra information such as Medicaid, PDP, or Extra Help info it must be on the application.
If the SEP requires any extra information such as Medicaid, PDP, or Extra Help info it must be on the application
If you need clarification for which period to select, you can ask your Ritter sales specialist.
7. Never Alter a Client’s Signature
Even though you may have the best of intentions, altering a client’s signature, or the associated date, on an application is strictly prohibited.
This rule extends to the SOA or any other documents that go with the application, and even your own signature or date as the agent. It’s always better to start a new application with your client or to apply late than to forge and falsify a legal document.
Even though you may have the best of intentions, altering a client’s signature, or the associated date, on an application is strictly prohibited.
Digital Signatures
Emailing or texting a prefilled application to a client provides a safeguard against signature alteration. The client controls when the application is signed, and nobody can alter it.
8. Make Sure the Application Is Complete
Every part of the application is important to us, the carrier, and your client, so it’s vital you make sure the application is complete. Check and double-check to make sure you’ve finished the application before submitting.
9. Submit the Application on Time
Once you’ve taken the time to review the application, be sure to submit it with the appropriate cover sheet, and any other required documents, within the specified time-period.
Applications can arrive at the carrier no later than 48 hours from the agent’s signature date. If you’re late, you risk being penalized by the carrier. Plus, why hold things up? A delayed enrollment is a delayed commission.
10. When in Doubt, Call for Help
Your business is serving your clients, and our business is serving you. If you have any questions about submitting an application, don’t hesitate to call Ritter for assistance.
Submit a Request Online
Besides calling us for help, you can always submit a question or request by clicking the Ticket icon in the upper right-hand corner of the Platform’s agent dashboard.
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