Beneficiary Privacy and Conflict of Interest

  • Protecting Beneficiary Privacy

As a Arkansas SHIIP counselor, you will have access to beneficiaries’ health information as well as personal identifying information like Medicare numbers and Social Security Numbers. You must handle this information carefully and keep it confidential to protect beneficiaries from fraud, identity theft, health-based discrimination, and other potential problems.

  • Only collect the information you need to provide the help the beneficiary has asked for (for example, you don't need a list of medications to help someone enroll in a Medigap plan).
  • Only share beneficiary information with people or agencies who are directly involved in providing the help the beneficiary has asked for (like a Part D plan, for example).
  • Don't keep beneficiary information on a laptop or in a file that you take out of the office with you.
  • Don't leave beneficiary information out on a desk or up on a computer screen where it can be seen by others.
  • Conduct counseling sessions in private where personal information shared by the beneficiary won’t be overheard by others.
  • If you believe beneficiary information has been lost, stolen or misused, contact your AR SHIIP Coordinator immediately.
  • If you believe a beneficiary has been the victim of fraud or identity theft, contact your AR SHIIP Coordinator the Arkansas SMP Coordinator immediately.

Conflict of Interest

Arkansas SHIIP counselors are trusted resources for Medicare beneficiaries. To maintain that trust, counselors cannot be allowed to profit in any way from their contacts with beneficiaries. AR SHIIP has adopted several rules to ensure that no volunteer has a conflict of interest that would prevent him or her from providing unbiased counseling.

  • Anyone who is currently associated with the insurance industry is prohibited from being a AR SHIIP volunteer counselor.
  • Anyone who could use their position as a AR SHIIP counselor to solicit business from beneficiaries is prohibited from being a AR SHIIP volunteer.
  • If a AR SHIIP Coordinator is unclear about whether a conflict of interest exists, the Coordinator should request a ruling from the AR SHIIP Director.
  • Potential volunteers cannot take SHIIP training until the Coordinator or Director has determined that no conflict of interest exists.
  • People who work for organizations that serve Medicare beneficiaries may be AR SHIIP volunteers as long as they do not use their position to solicit business of any kind.
  • SHIP Special Access to 1-800-MEDICARE

CMS is beginning broad implementation of a system designed to enhance the interaction of SHIP counselors with customer service representatives at 1-800-MEDICARE. A SHIP-only number has been established that will allow you to reach customer service representatives at 1-800-MEDICARE.

When a counselor calls, they must enter his or her Unique ID. Counselors must enter the full Unique ID. If the counselor enters his/her Unique ID correctly, s/he will receive a very brief list of options from a recorded menu. If the counselor does not enter the Unique ID correctly or enters an invalid Unique ID, s/he will hear the regular menu of options presented to all callers who call 1-800-MEDICARE. If counselors report that they see no difference in the menus, they are likely entering invalid Unique IDs.

Assuming that the correct ID is entered, the counselor will hear a very brief menu of options as follows:

  • Press 1 for General Medicare issues (including Part D questions or plan enrollments)
  • Press 2 for hospital issues to reach a Part A agent
  • Press 3 for physician issues to reach a Part B agent
  • Press 4 for medical equipment issues to reach a DME agent
  • Press 5 to disenroll from a Part D plan

The efficiency in this system comes from the counselor selecting the appropriate option from this menu. The menu is designed to be very short and to the point to encourage counselors to listen and select the appropriate option. It is purposely not as long and descriptive as the menus for accessing customer service representatives through the 1-800-MEDICARE number, as CMS assumes SHIP counselors can use the shorthand menus described above. Counselors who do not choose the appropriate option will not see increased efficiency from the system.

It is important to note that this number will not bypass or put a SHIP counselor in any kind of priority wait for a customer service representative. If there is a wait time for callers to 1-800-MEDICARE, the SHIP counselor will experience that wait. However, SHIPs have reported shorter call times and more efficient calls using the new system.