Selling Health Insurance – The Importance of Network Participation: Article 13 in Randy’s Closing Insurance Sales series.
Hi everybody.
For those of you I have not met,
My name is Randy Mc Arthur.
In one of my previous articles I mentioned network participation. As we all know, carriers and providers can choose whether or not to participate with networks. Carriers can choose to participate with existing networks, build their own networks or provide straight fee for service coverage. Health care providers can choose to belong to networks or not. It’s really very simple in theory but confusing to the public in implementation. Here’s why:
The network in a lot of cases is more important than the carrier itself. For example, one of the national carriers that I represent offers the customer a choice of networks, ranging from very spotty coverage to excellent coverage on the same suite of products. Well the customer just wants to know the same 3 old things. He wants to know; what’s my co-pay?, what’s my monthly payment?, Can I go to every single last doctor on this planet ?(or any other one for that matter?)
He does not want an education on network participation and the excruciatingly painful consequences of choosing the wrong one, BUT, you still have the responsibility to give him one if you want to do the right thing by helping him insure that through his own choices, he has made only necessary cost effective decisions that guarantee he has protected himself from a catastrophic life changing medical event.
Let’s get back to his three questions. Here is one way you can start to answer them.
Question 1: What is my co-pay at the doctor’s office?
Answer: What is more important to you, your copay at the doctor’s office for the visit only or the amount that the insurance company will pay should that appointment lead to a much larger claim? Remind him you are still looking at the very same policy written by the very same carrier but participating with a different network.
Get to know the networks that your carriers use so you can offer accurate hypothetical scenarios. Never try to actually forecast the future because neither you nor the customer has a crystal ball.
Basically, your goal here is to move your customer’s focus from making his decision based on one small financial factor (doctor’s copay) to the larger picture of unknown cost of medical treatment and more importantly which doctors will be providing it. Because, NO, he is never going to find anything on this planet that is all things to everyone, very cheap, very easy and readily available, medical or otherwise.
You have to persuade him to embrace your point of view to his benefit. Like always, you just need to ask thought provoking questions in an appropriate manner. I’m happy to help you with that.
Question 2: What’s my monthly payment? Before I respond – It’s disclaimer time. I Norman Randolph Mc Arthur am by no means advocating that you as an agent try try to forecast underwriting for anyone. My response is only relevant to network participation and selection.
Answer: At this time, which is more important to you, your known premium cost or the potential unknown medical cost that you are buying insurance to pay for in the first place? When the customer responds – just listen to what he says and to what he doesn’t say. Take notes so you can help him get just as close as possible to what he needs and hopefully some of what he wants. Remember, his answers and comments should generate more questions right up until he asks you “How do we get started?” if you are really trying to help him.
Question 3: Can I go to any doctor?
Answer: Yes, while that is possible, is there any reason you would like to? Listen and take notes. The customer may have a concern that is very easy to address at this point that will be impossible for you to overcome during the Overcoming Objections phase of closing because you got blind sided.
.
His concerns could have stemmed from a past problem with one or more previous situations. He could have had a referral requirement that he did not know about. He could have had a medication or sedation pre-authorization requirement he did not know about or he could have been placed in an inappropriate network that did not fit his expectations in order to save him a few dollars a month. Who knows? That’s why you have to listen.
In the end, I’m in North Carolina and here we have a lot of networks with one of them being much stronger than the rest. When the customer affords me the opportunity to explain network participation, the carrier becomes a secondary consideration and we get to look at true risk management instead of just name recognition. It makes it easier for the customer to understand how he is benefiting from your point of view.
On the other hand, if you get a pure co-pay customer that does not want to listen to you, just offer him the lowest co-pay, but I’d advise you to take that commission as earned only, because as soon as someone else offers him a lower monthly premium with the same co-pay or a lower copay with the same monthly premium you are getting charged back.
I did not get to allowables, fee for service, or HMO vs PPO due to time. In my opinion, it is imperative that an agent be able to explain network participation fully if he cares about the customer.
My personal mission is to; first, only and always do the right thing to help people insure that, through their own choices, they are making the best decisions they can make to guarantee their success in everything they do.
If I can help you in any way just give me a call at (919)781-2018 or email me at randymcarthur@ymail.com. I look forward to hearing from you. Good luck in your endeavors and God bless you.
Thanks
Randy Mc Arthur
Thanks for visiting my insurance leads blog.
Cheers,
Mac