Quality health plans & benefits Healthier living Financial well-being Intelligent solutions Aetna Medicare Physician Marketing Program

Size: px

Start display at page:

Download "Quality health plans & benefits Healthier living Financial well-being Intelligent solutions Aetna Medicare Physician Marketing Program"

Emil Nicholson
6 years ago
Views:

1 Quality health plans & benefits Healthier living Financial well-being Intelligent solutions 2017 Aetna Medicare Physician Marketing Program

2 Provider Marketing Opportunities: Aetna has a strong network of physicians in Texas and we are teaming up with Aetna producers to work with the in-network physician groups: As a part of a new Aetna Medicare Network Communications campaign As a relationship opportunity for both referrals and marketing events. After the agent has established their physician marketing plan and completed the required trainings, they will be officially assigned to a provider: No other agent will have an opportunity to market with your physician group once you are assigned. The type and amount of marketing will be determined by business plan development (Fast Track) through your up-line and your local Aetna Medicare Broker Manager. 2

3 Provider Marketing Opportunities: The VALUE of a good physician relationship: 1. Physicians provide the BEST leads! When a patient calls a physician office about health insurance they are looking for plan information that the physician office participates in. 2. Physicians cannot recommend a specific plan. Physicians must remain impartial and can only inform the patient on what plans the physician office accepts. Only a selling agent can recommend a specific plan for the patient. 3. Physician offices are good locations for marketing/educational events. 4. Physician offices promote your agency! Marketing fliers, business cards, and event promotions. 5. Market and plan disruption. Physicians need assistance when health plans leave the market or when an office terms with an MAPD carrier. 3

4 Prepare: Know Your Products 4

5 Prepare: Know your products Make sure you can present the Aetna MAPD product portfolio with a focus on the plan selling points. HMO Prime product designed to compete with the lowest costsharing health plans HMO Premier product that has a large local network of Doctors and Hospitals Two PPO products the Choice PPO and Value PPO that have a National Network of providers for greater access to care Medicare Supplement Plans offered through Aetna Senior Supplement 5

6 Have A Story To Tell 6

7 Have a story to tell What is unique about your agency? What products and services do you offer, and how can you help your physician office grow their business? Example: My name is John Smith and I m an independent agent with John Smith Insurance Agency, specializing in Senior Health Care Products: Medicare Supplement, Medicare Advantage, Part D Rx plans. I can assist seniors qualifying for financial assistance to help cover the out of pocket costs of their doctor, hospital, and prescription drugs. I also offer educational classes to help seniors understand how Medicare works, the importance of preventative medicine, and the questions they need to ask when choosing a health plan. 7

8 Physician Marketing Kit 8

9 Provider Marketing Opportunities Physician Marketing Kit You will be given a physician marketing kit that contains the following: 1. An Aetna call script that highlights the partnership and the value you bring to the physician office 2. The selling points of the Aetna MAPD product portfolio 3. The Office Manager Questionnaire (Fact Finder) 4. template for provider engagement reporting 5. Provider Welcome Packet 9

10 What is your story with Aetna? Aetna Physician Marketing Script: My name is and I m with ; I have been assigned to your physician group/office as your local Aetna Medicare Network Communications Representative. We are reaching out to all the Aetna Medicare physicians to educate the office on Aetna s Medicare Advantage plans. Here is your Provider Communications folder. (let the office know what the initial fliers/communications are) We will be dropping off important provider communications throughout the year that we will add to your Aetna folder. I will be your contact person if you have any questions about Aetna s Medicare Advantage plan benefits or patient enrollment options. (We also have a brief survey that I would like to discuss with your office manager if he/she has the time today.) (You may also request to schedule a Lunch & Learn for your office staff if you would like to learn more about Aetna s Medicare products and procedures.) 10

11 Prepare: Know your products - 2 minute elevator sales pitch! Aetna Medicare Prime HMO: Our lowest cost-sharing HMO designed to compete with Texan Plus and Cigna Health Springs. This is a great choice for prospects looking for low-cost medications and low co-payments for physician and hospital services. The Prime HMO is a HVN High Value Network that is designed for proper coordination of care through our many Primary Care collaboration partners. Offered only in Harris, Ft. Bend, Montgomery, and Jefferson. Aetna Medicare Premier HMO: Another zero premium HMO option that is available in Houston and surrounding counties. This HMO is designed for the client that wants both a zero premium option with Rx and access to a large physician network. The Premier HMO has one of the, if not the largest doctor and hospital networks in Texas. Aetna Medicare Choice PPO: A 4 Star rated PPO MAPD with a Nationwide Network of Doctors and Hospitals to choose from. The Choice PPO is competitively priced at $19.00 per month (A lower premium than any standalone Part D plan without a deductible) A true alternative to the higher cost Medicare Supplement plans. The Choice plan provides both in and out of network benefits and does not require referrals to see other doctors. Aetna Medicare Value PPO: A 4 Star rated PPO MAPD with a Nationwide Network of Doctors and Hospitals to choose from. The Value PPO is competitively priced at $ per month and includes a very broad formulary with high cost medications at lower tier co-payments. A true alternative to the higher cost Medicare Supplement plans. The Value plan provides both in and out of network benefits with the same cost sharing both in and out of network for doctor and hospital services, and does not require referrals to see other doctors. 11

12 Physician Office Survey 1. Are there any pressing issues, Aetna network or patient access to care concerns, we need to escalate? 2. Are there any physicians/doctors here that are no longer accepting new Medicare patients? 3. Are there any physicians/doctors here that are currently wanting to grow their Medicare patient panel? 4. What other carrier MAPD plans do you participate with? 12

13 Physician Office Survey 5. Would you like additional training for your office to educate the staff on policies and procedures, including STARS information? 6. Would you like Aetna Medicare Marketing fliers or brochures for your patients to educate them on what Aetna Medicare plans you participate in? 7. Do you have any interest in co-marketing with Aetna Medicare? 8. Would you like to have a representative to help your staff qualify your Medicare patients for financial assistance programs? E.g. Extra Help with prescription drugs (LIS) Medicaid, and other cost-sharing assistance? 13

14 Reporting Procedures Each participating Broker will be provided an official list of physicians to market to and an template to fill out after the initial outreach was made. 1. Name, address, and phone number for the physician office. 2. Was the Welcome Kit received? 3. Are there any pressing issues, Aetna network or patient access to care concerns, we need to escalate? 4. How was the initial response to the outreach? 5. Was the physician survey filled out? (attach questionnaire) 6. What are the next steps to be taken? 14

15 Important Things To Remember 15

16 Important things to remember Agent/Brokers are NOT Aetna Network Managers or Aetna Member Services Representatives. Aetna has processes and procedures in place for both Physician/Network and Access to Care/Member issues. For Member Issues: Have the member contact Member Services; the number on the back of their Aetna MAPD card. For Physician/Network Issues: Have the physician call the number inside the Welcome Kit. your Broker Manager who will contact Aetna s network department for an outreach to the physician office. Provider Help Line:

17 Know what you CAN and CANNOT discuss Do Not: Discuss Physician contracts or reimbursements. Act as a network Manager Try to obtain patient referrals for the physician office Do: Discuss plan benefits and help provide an explanation of benefits. Talk about Aetna marketing materials and possible future co-marketing opportunities. Discuss the services you provide as an Aetna Producer. Help members schedule their preventative checkups with their physician. 17

18 Review: Getting Started 1. Choose 5 physicians: your physician selection to your team leader. 2. Print and review the physician marketing material. You will be provided an Aetna physician marketing folder and the necessary documentation in pdf or word format. 3. Make your outreach and deliver the Provider Communications Folder. 4. Office Manager Questionnaire: Have the office manager fill out the office manager survey. 5. Complete the reporting and send to your Aetna Broker Manager. 6. Once these steps are completed, you may choose another 5 physicians to market with. 7. Aetna will provide continued material for the agent to add to the Provider Communications folder throughout the year. 18

Providers who see Empire Medicare Advantage HMO members also are considered contractually eligible to see Empire D-SNP members.

Providers who see Empire Medicare Advantage HMO members also are considered contractually eligible to see Empire D-SNP members. Empire BlueCross BlueShield FAQs for 2017 D-SNP Plans Introduction: Empire BlueCross BlueShield is offering Special Needs Plans (SNPs) to people who are eligible for both Medicare and Medicaid benefits