Verifying Enrollment and Plan Materials

You may think that once the application is submitted, then you’re all set, right?

Not quite, there is still some work you can do to verify your client’s enrollment and help guide them from the signing up process to using their benefits.

So, what happens after you submit the application?

Within 10 days of receiving the enrollment request, the carrier will provide one of three documents: an acknowledgement notice, a request for additional information, or a notice of denial.

The acknowledgement notice will include member details like member ID, prescription details, and information about using their coverage.

Your client should receive this notice prior to their effective date, but enrollments completed closer to the effective date may be delivered later.

In some cases, the letter may notify the client that they are still awaiting final approval from Medicare. If so, the carrier will send another letter once the enrollment is finalized.

If your client receives a request for additional information or notice of denial, you can assist your clients with the appropriate next steps to resolve the issue.

Additionally, you’ll generally be able to check enrollment status in the carrier’s portal, so you can stay on top of those details.

Speaking of carriers, while they all have similarities like sending a member ID and welcome kit, they also have variations, like some will give the new member a welcome call. Let your client know what to expect with their enrollment, so they’re not caught off-guard by the welcome call.

Whether it is confirming enrollment or helping with a request for information, you can continue to give your client peace of mind even after their application has been submitted.

There is still one more step to take to ensure client satisfaction. We’ll cover that in the next lesson.

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