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Humana 2016 Medicare Recertification
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Humana’s annual on-line agent Medicare recertification training must be completed by November 30, 2015. All current Medicare certifications expire on December 1, 2015. Recertification must be completed in order to be eligible to offer and enroll in any Medicare products with a 2016 effective date. In addition, recertification is required on an annual basis in order to receive commissions on any new or previously enrolled Medicare product. Recertification is only for agents who are currently certified to offer Humana 2015 Medicare products.
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JOB AID: How to Navigate AHIP Recertification (AP-101)
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Humana Medicare Recertification Schedule
- July 21st – Launch MAPD recertification
- August 3rd – Launch PDP recertification
- November 30th – Medicare Recertification period ends – recertification must be completed by 5:00pm EST
- December 1st – Sales privileges terminate for any agent that did not recertify
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Humana Initial Medicare Certification[dt_gap height=”10″ /]
Agents who are not currently certified to sell Humana Medicare Advantage plans may become certified by first completing the on-line Delegated Pre-work module and then attending a Medicare Advantage classroom training.
As a reminder, the 2016 on-line Delegated Pre-work module has been taken off-line as of Monday, June 30th. Agents who began these modules prior to June 30th have until July 10th, 2015 to complete both the on-line training (including AHIP) and face-to-face training. Any agent who started his/her Medicare Certification process before June 30, 2015, who does not complete both the on-line Delegated Pre-work module (including AHIP) and the face-to-face training by July 10, 2015 must begin the process again using the 2016 on-line Delegated Pre-work module (including 2016 AHIP) and the face-to-face training.
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[dt_gap height=”10″ /]AHIP Training & Testing[dt_gap height=”10″ /]Similar to last year, Humana is partnering with AHIP in providing training and testing. AHIP works closely with CMS in developing the material and they are highly regarded in the industry. The AHIP certification must be taken in order to represent MA or PDP products.
The AHIP course will include Fraud, Waste and Abuse (FWA) as well as the CMS General Compliance Training. The training has been designed to strengthen an agent’s knowledge and to better equip them to:
- help potential members to understand the basics of the Medicare program plans and benefits
- help potential members learn about the different types of Medicare Advantage and Part D prescription drug plans, eligibility, and how to get covered services
- comply with marketing and enrollment requirements under the Medicare Advantage and Part D programs
The AHIP training and testing can be accessed through the Humana Agent Portal. You will be required by AHIP to re-register with them this year even if you registered last year. There are 5 AHIP modules but you will only be required to open and read module 4 & 5 since you are recertifying.
However, you will be tested on all 5 modules so we strongly recommend reviewing all modules prior to testing. You will have 3 attempts to pass the AHIP test with a minimum passing score of 90%.
Upon success completion of the final AHIP exam, the Fraud, Waste and Abuse (FWA) course will “unlock” and become accessible. Once you have completed the required course work, the FWA exam will “unlock” for completion. You will have an hour to complete the 10-question exam. You must score 90% to pass the exam but are provided as many attempts as needed to do so.
Successful completion of the AHIP, FWA and CMS General Compliance training and testing are required before a passing score can be transmitted to the Humana Recertification course.[dt_gap height=”10″ /]
AHIP Fees and Reimbursement[dt_gap height=”10″ /] The new discounted charge for the 2016 AHIP training is $125.00 per registration when accessed via the Humana Agent Portal. The general fee for the 2016 AHIP training has increase to $175.00 per registration.
We value your partnership and will reimburse your testing fee under the following circumstances:
- you took the courses through the Humana Agent Portal, and
- you have successfully enrolled ten (10) MA OR forty (40) PDP January 2016 effective members – members must be accreted with CMS by March 6, 2016.
After completing the AHIP testing successfully you will have the option to purchase CE credits.
IMPORTANT: After printing your transcript certificate, don’t forget to “click” the “send my exam completion to Humana” button at the bottom of the page. If you have taken the AHIP testing through another carrier’s site, access AHIP again through the Humana agent portal and send the exam to Humana.
After completing the AHIP portion of testing and sending the transcript to Humana, you will continue on to complete the Humana portion of recertification. [dt_gap height=”10″ /]Humana Training & Testing[dt_gap height=”10″ /] Similar to previous years, there will be several modules to complete on-line. You must take the AHIP recertification courses prior to beginning the Humana modules. Humana modules will include:
- Code of Ethics
- Safeguarding Protected Information (PI)
- Humana Product information
You will have 3 attempts to pass the Humana test with a minimum passing score of 85%. Upon successful completion of the Humana test, return to “My Current Exams” to print your certificate of completion.
The below job aid will assist you in accessing and navigating the Humana Training & Testing through the agent portal as well as the AHIP site.[dt_gap height=”10″ /] [/vc_column_text][/vc_column][/vc_row][vc_row margin_top=”20″ padding_left=”40″ padding_right=”40″ bg_position=”top” bg_repeat=”no-repeat” bg_cover=”false” bg_attachment=”false” padding_top=”40″ padding_bottom=”40″ parallax_speed=”0.1″][vc_column width=”1/1″][vc_column_text css=”.vc_custom_1436534647110{margin-top: 15px !important;margin-right: 15px !important;margin-bottom: 15px !important;margin-left: 15px !important;padding-top: 30px !important;padding-right: 30px !important;padding-bottom: 30px !important;padding-left: 30px !important;background-color: #eaeaea !important;}”]
Humana Pre-AEP Applications – Important Process Change!
As you know, CMS guidelines state that agent assisted “AEP” applications received prior to the official start of AEP MUST be investigated for potential agent solicitation. This year, it’s important you know that any agent assisted 2016 AEP applications received by Humana before October 15th will be investigated AND the member’s application will be rejected.
[dt_gap height=”15″ /]What Does This Mean to Agents? [dt_gap height=”10″ /] Agents should have a clear understanding of the Pre-AEP application guidelines in order to give proper instruction to members and create a positive member experience. As a reminder, during Pre-AEP, agents are allowed to meet with beneficiaries, assess their needs, review plan changes and options, give a full product presentation, and make recommendations on coverage that will best meet the beneficiaries’ needs over the next year. One of the most important things to remember during Pre-AEP is that while agents can assist a beneficiary in completing a paper application they cannot encourage completion, solicit, accept, take possession of, or “just hold on to” any applications for the 2016 contract year prior to AEP, October 15, 2015. Since agent assisted applications received prior to October 15 will now be rejected by Humana, we would like to share some important changes to our guidance and get your feedback as we go through the process development stage. Here is some Pre-AEP guidance we have been working on:
- Agents should instruct the beneficiary to wait to sign, date and mail the AEP application until October 15th or later to:
- avoid rejection of app, AND
- reduce agent investigations.
- AEP applications received prior to 10/15 will be rejected and the beneficiary will be notified by mail that Humana was unable to complete their enrollment. The letter encourages the beneficiary to:
- call in to Humana to enroll over the phone, OR
- request that an agent come back to their home to assist them.
- In an effort to remind members when to mail in the application, the business reply envelope will have a message printed on it advising them not to mail before 10/15.
- Agents may wish to ask the beneficiary to initial the statement on the envelope indicating they were instructed NOT to mail the application until 10/15 or it will be rejected.
- Another possible way to ensure your client remembers not to mail the application is to use a large Post-it note and write a reminder not to mail the application until 10/15. Use the Post-it to cover the backing of the envelope to prevent it from being sealed. The client would have to physically remove it to seal the envelope.
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