Friday, April 21, 2006

Stupid Carrier Tricks...

So Medical Mutual of Ohio (a fairly large, state-wide carrier) just bought Summit Insurance (a much smaller one). The deal’s been in the works for at least six months, and was finalized and announced a month or so ago.
So far, so good.
The actual transfer of business is set to take effect on May 1, so the carriers scheduled a series of meetings to familiarize brokers (agents) with what the sale means, what changes we can expect, and to answer any questions we might have.
Yesterday, I attended the last of 4 locally scheduled broker meetings:
First, the representative from Summit got up and spoke for about 45 minutes (which was approximately 35 minutes longer than was necessary). One could tell that the gentleman was not pleased to see his beloved company fade into oblivion, but we got that message pretty early on. He fielded a few questions, answering some, and passing others to the MMO person.
When Mr Summit was finished, he turned the meeting over to Ms MMO. She also spoke for a bit longer than was necessary.
There were, of course, a number of important (and urgent) items, but the two “take away” pieces were:
■ Although most maintenance prescriptions will (theoretically) transfer over from Summit to MMO, controlled substances and compounded meds will not; they will have to be re-prescribed. While this may not sound like a big deal, it certainly could be: physicians are restricted in how many of these scrips they can write for a given individual. Ooops.
■ Any procedures pre-authorized by Summit, which are scheduled for May 1 and later, must be re-authorized (by MMO). Granted, this makes sense from a claims standpoint, but announcing it only 10 days in advance is, well, stupid. How many such procedures will now have to be re-scheduled, as well?
The icing on this particular cake, however, took place near the end of the meeting. Our presenters had been unable to answer about half of our questions. So, I raised my hand:
I have a more big picture question. Y’all have been working on this for over 6 months, and yet you’ve been unable to answer a lot of the questions we’ve asked today. And, this is the fourth such meeting you’ve held. We have no idea what questions were raised, and left unanswered, in the other three meetings. So, will there be an email or fax that addresses all these questions for us?
Ms MMO replied that “that’d be a great idea. But we haven’t been writing them down, so we don’t know what all of them were.
Yeah, me too.
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