Enrollments may pend or end up being denied for many different reasons. Often, it is a result of human error, either on the part of the beneficiary or the agent. Unanswered questions; incorrect plan selections or Medicare ID numbers; and enrollments faxed to the wrong location are all examples of mistakes that may prevent a beneficiary from receiving coverage.
One of the great things about the number of enrollments that come in during the AEP is that it gives carriers a chance to see trends developing that may go unrecognized during the lock-in period. Here are the five most common errors made by agents this year:
1. Incorrect Medicare ID Number – This could occur either because it was written incorrectly by the beneficiary or agent, or because it was keyed incorrectly when completing online enrollments.
2. Incorrect Plan Selection – There are a few reasons this error occurs. Sometimes, the agent may select a plan that is not available in the county where the member resides. We often see this in situations where an individual lives on the border of 2 counties. Other times, the agent simply checks the wrong box accidentally.
3. Incorrect Initial Receipt Date – Wrong day, month or year for the IRD (e.g. 10-21-13 instead of 10-21-12)
4. Incorrect Proposed Effective Date – It is hard to get into the habit of writing 1-1-13 on enrollments this time of year. Double check your enrollments to make sure the beneficiary should actually be getting an AEP effective date of 2013, instead of one for 2012.
5. Enrollments Faxed to the Wrong Number – Make sure that all of your enrollments are submitted to the correct fax number. Sending them to the wrong number can result in enrollments not being received and therefore not being processed, but just as importantly, it can result in a breach of Personal Health Information (PHI).
Even the most conscientious agents are not immune to these simple errors. So, always remember to double check your hard work!