11/18/2008
How to use the Scope of Appointment forms for Medicare clients
We appreciate everyone's compliance with the recent Medicare Improvements for Patients and Providers Acts of 2008 (MIPPA) guidelines and wanted to provide additional clarity regarding the use of Scope of Appointment forms. We filed the general Scope of Appointment form with the Centers for Medicare & Medicaid Services (CMS) and received approval. You are, however, permitted to use Scope of Appointment forms from other carriers.
CMS has created the Scope of Appointment form to ensure that beneficiaries are clearly informed in advance of the types of products to be reviewed during an appointment. Prior to a face–to-face appointment, a beneficiary must first agree to the products and services that will be presented.
Scope of Appointment forms:
- Must be filed for a minimum of 10 years
- Must be collected in advance of an appointment (via fax, email or U.S. postal service)
- Cannot be signed at the time of a scheduled appointment
- Are not required if a verbal Scope of Appointment form has been acknowledged and recorded during a phone conversation
- Are required prior to discussing benefits with an additional person who unexpectedly joined an appointment that you already had scheduled and documented scope
- May not be distributed at educational events
- Do apply to third-party entities
- Are not required for a beneficiary to attend a seminar
If the beneficiary walks into your agency or initiates a face-to-face meeting, you will not be required to collect the Scope of Appointment form in advance. Instead, you can note “Walk-in" on the document and collect it during the appointment. If a beneficiary wants to discuss other products or services not agreed to and documented in advance of the appointment, you must schedule another appointment at least 48 hours later to discuss these additional topics.
We are currently reviewing our policy regarding the proper handling of this form and will update you as our policy and procedure mature. At this time, please maintain the Scope of Appointment form in your files. (You do not need to submit it with an application.)
Should you need additional information the CMS has provided the following reference guides:
If you have any questions, please talk to your Regence Sales contact.
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