- Hi, I'm Sylvia Gordon.
- Hey, and I'm Rebecca Gordon.
- And I'm Edgar Wagner.
- And this is the Weekly Wednesday Wrap-Up--
- On-location.
But do you know where we are?
- Get a map.
(all laugh)
(upbeat music)
- Hey, in this episode we're gonna talk about
prior authorization.
- Very, very fascinating
for a dry subject. - Fascinating.
- And other stuff.
So let's just hop right into
prior auth. - Other stuff.
- Prior auth.
- All right, so with original Medicare and Med Supp,
you don't have to have prior authorization.
- Yet, but it's something they're kicking around.
Because they think it could save money.
- It curbs costs, right?
It can sometimes dissuade those unnecessary
tests or treatments that maybe people don't really need.
It's kind of a really, that's a gray area,
it's a touchy line.
I'm not going there.
However, what we're seeing,
I'm gonna have all these comments, like, "Yeh!"
That with Medicare Advantage,
four out of five Medicare Advantage enrollees
are in plans that are requiring prior authorization
for some services.
So this blue grid right here,
but this makes sense, right?
'Cause this is our real high-end services,
durable medical equipment, skilled nursing,
drugs, inpatient.
So we're really not surprised about that.
But what's really surprising is this part.
So, and especially this 12% in the green,
preventive services.
- Right, so fewer people,
very few people have to have prior auth for preventative,
but to me, that seems like something
that people would want to prevent.
Make that impossible to have prior auth.
Because, from the consumer's point of view,
and the agent's point of view,
prior auth is a hassle, and a hurdle,
- Oh, total. - And a barrier
to a necessary treatment,
to just slow down the process.
There's no positive on the side of the consumer.
- So we saw this first take place
with step therapy and Part B drugs,
where they started to use prior authorization.
- They had step therapy on Part B drugs,
now they're doing prior auth also.
Just make it just that much harder,
because they are that expensive.
- And it's a pain in the butt.
I mean, we've had a couple colleagues with us
that desperately needed knee replacement,
man could not walk, and I mean,
it took a long time - Years.
- to get this pushed through.
It was crazy.
The average person would've just given up,
and cut their leg off.
- Well, one of the things that you as an agent need to do
is advocate on behalf of your clients,
is tell them, if the prior authorization is denied,
- Appeal. - Appeal.
- Appeal. - Very few people
are appealing.
That's the good kid in school,
they just took no for an answer.
We never take no, that's why we're in sales.
Help your clients realize to keep fighting,
- Keep fight, yeah. - And they can get that
eventually approved.
This is just a part of insurance.
- So that's coming down, we're seeing that.
- So, we just got back from...
New Orleans. - Lucky.
- And I don't know, was this like our fifth year?
We have our Rising Stars trip, it's for new agents.
So either new agents, that you're just new in the industry,
or you're just, you can be a big agent
that's been in the business 30 years,
but you're new to Gordon Marketing.
So you can win our trip once,
it's a very easy trip to win,
it only takes 50 Med Supps. - So fun.
- We don't care, any company that's with us,
you can sell all of 'em,
sell a couple with all of 'em,
or with United American, it's even easier.
It's only 25 Med Supps, certain plans.
- Something like that. - And then,
if you sell so much, I think it comes up here.
So many annuities,
or so much life, - Life.
- or so much bla bla bla,
it's very easy to win, you can win it once.
- We want you to win. - And you can't win it
if you've won any of our other trips or conventions.
Yeah, we want you to win it,
to come spend time with us, - Oh.
- and get to know us,
and see our other division managers.
And there's some great videos on it on YouTube.
- That's your dad.
- My dad.
Plays the trumpet.
- Seriously, it's one of my favorite cities.
- Saxophone town. - It probably is
my favorite city.
In the U.S. - If you went on our trip,
tell me in the comments
what your favorite part of the trip was.
And if you'd like to go on the trip, talk to your marketer,
because we start the wish list for 2021,
it's always in January.
- And one thing, I always wanna say this.
Is let's say that you're not a big partier.
'Cause sometimes, people think of New Orleans
as Bourbon Street. - Oh, yeah.
- That's not us, so that, I'm just telling you.
If you are same spirit as me,
the history, the beignets,
the just listening to jazz street musicians everywhere,
this city has something for everyone.
- Right, I don't drink.
I have a blast there. - It's not just,
it's not Bourbon Street. - I also don't
stay out very late. - Right.
- I don't stay late, either. - I'm the boring,
early-to-rise lady.
- People go have fun after we go to bed.
- Yeah, so that people that wanna go next year,
if you wanna go, let's work with you to get you there.
- You'll love it. - The World War II
Museum's there, it's one of the best museums in the country.
And I'm hoping we're gonna take people there next year.
It's on my list. - Done.
(upbeat music)
- Hey everybody, it's Randy Pierson,
vice president of life and annuities for Gordon Marketing,
and believe it or not, it's that time of year again,
yes, it's Madness in March.
Our Life & Annuity Expo is March 5th from eight to five,
and we want you to be there.
We've got three amazing speakers,
we've got over 35 life and annuity carriers and vendors
to help show you how they can assist you
in taking your business to the next level this year,
and of course, we have our ever-popular speed dating round.
It's gonna be amazing.
So, remember, March 5th at the Renaissance Marriott
in Carmel, Indiana, from eight to five, you wanna be there.
(upbeat music)
- So, the question of the day.
- So the question of the day is, (sighs)
- Over-the-counter benefits. - Oh!
(Sylvia laughs) - I forgot.
- You had one job.
- I had one job.
- Because now is the time, - I woke up--
- They need to sign up their,
make sure their people are using
their over-the-counter benefits.
- And it's quarterly, right?
- So-- - So get up, get out there,
call 'em, see if they're signed up,
help them sign up. - It's a great touch
to stay relevant with your client.
To make sure that they're ordering the benefits,
it's gonna tie them in closer with you,
with the carrier, they get fabulous vitamins,
and you know what I did?
Is I took the catalog, and I went to CVS,
and I just, I put in my cart
everything that would equal the amount of money
that this particular plan had.
I was shocked at how much stuff was covered.
- And how many people don't take advantage
of their benefit. - Shocked.
- So, some companies are having trouble right now
with their over-the-counter program.
If you have experienced problems
with over-the-counter benefits,
let us know in the comments. - Let us know.
We wanna know. - We want to reach out to you
and help you, because we are aware
there are some hurdles right now.
And that's just the beginning of the year.
That's always, there's always this stuff.
We are doing an ebook.
- Oh my gosh, our ebook is insane.
So look, good chance you've seen last week's video,
where we told the nunchuck story.
We have a better story, a different story.
But we want your stories.
So if you've already given us one,
if you've given us two, but some more crazy things,
send them to us.
The thing that I realized in reading these stories is
people have no idea what agents go through.
- Right.
- I mean, it has floored me what agents have gone through.
- And they just blow it off.
They're like, "Oh, yeah, yeah.
"That happens all the time."
- It just, and agents are discarded
as doing nothing for their clients.
It is crazy.
This has really, I don't wanna say raised my respects,
I've grown up in the insurance industry,
but I think it opened my eyes more.
I have some of my stories, nothing like these stories.
- You know, Dad grew up, he was a life insurance agent.
His stories were different.
Maybe he just didn't tell us 'cause we were kids.
- They were about dogs.
- It was always about dogs.
- Dogs on farms.
- But these stories are--
- Insane.
- There's no dog stories.
- So tell us-- - That'd be tame.
- Okay, so I wanna tell Bennett's story.
So Bennett, she was going on - I think she's gonna go
to prison. - her very first appointment.
She was going out with Jan, her trainer.
And they get to a house of a lady,
and the lady opens the door,
and they come in, sit down, she's nervous, you know,
it's her first appointment.
And so she starts doing what her trainer taught her
in her presentation, she's doing.
And the lady goes, "Well I just got outta prison
"for murdering my husband."
(Rebecca laughs)
- That's awesome.
- So, Bennett's like, - That's great.
- Whoa, like I don't know,
- This wasn't in
my training manual. - What I'm supposed to respond
to that. - Right.
- And she said she was like, not exactly remorseful.
I don't know. - Kinda matter-of-fact?
- Yeah.
And she's sitting in somebody's house.
You know, when you're an agent,
you're in people's houses, you're on their territory,
and you just don't know, is the person crazy?
- [Rebecca] Right.
- Is she dangerous?
- Is there something under a cushion?
- And she's like, what do you respond to that?
What do you say?
She's like, "Am I supposed to say,
"'Well, welcome back from prison,'?"
Are you supposed to say, - How was the food?
- "How long were you in prison?"
"How was prison?"
She didn't know what to say.
She was like, "It was just so awkward,
"I just looked at her with my mouth open,
"looked at my trainer, who was also like,
"'I don't know where to go.'
"And we just proceeded, and did the presentation,
"and took the app." - That's good.
- But she came back, she's like,
"Oh my God, I never thought about,
"I'm gonna go into houses of people
"that could be crazy." - Colorful.
- Could be - Very colorful.
- Convicted murderers.
- So this, I am convinced,
we will win some award with your stories.
So please. - So tell us your stories,
ask us to call you in the comments
if you don't wanna take all the time to type it up,
we'll type it up for you.
Tune in next week, when we'll be back
with our Wednesday wrapping up what happened in insurance.
- Have a good one.
(upbeat music)