Thursday, March 26, 2015

Outstanding Carrier Trick

A few months ago, I "inherited" a small group from a colleague transitioning out of that side of the business. One of the challenges with this process is that the new agent doesn't have any of the original paperwork (applications, etc) to refer to should the need arise.

Yesterday morning, I received a frantic call from the employer: one of her employees had recently changed doctors, and needed to have a prescription filled. For some reason (I'm still unclear on the specifics), the pharmacist couldn't get the okay from the insurer because the employee's birth date didn't match what the carrier had on file.

The employer called me to see if there was anything I could do to resolve this as quickly as possible, preferably by the end of the day. I explained that insurance companies (very) rarely move that fast, but that I'd see what I could do.

Fortunately, I had the contact info for the carrier's rep. Even though this wasn't his area (he toils on the individual side), he was able to access the original application to confirm that the records didn't match. He quickly helped me get to the proper department, where I explained the problem to a very nice lady, who told me that all she needed was an email with some basic info (group and ID number, and correct date of birth) and that we needed this resolved ASAP. I immediately fired that off, and let the employer know that we'd at least gotten a good start, I also advised her that she should urge the employee to wait until (at least) today to try getting the scrip filled, since it generally takes a while for these things to resolve.

Oh me of little faith!

About an hour later, I got an email telling me that "[t]he correction has been made to the drug system.  She can pick up her Rx now."


So, kudos to Medical Mutual of Ohio, and especially Mike B and Nancy K for a job (very) well done.
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