Getting Paid by Medicare Advantage Plans is proudly presented to you by National Association for Home Care & Hospice. Thank you. We hope that you enjoy your course.
Description:
Medicare Advantage Organizations and all the plans they offer are continuing to add thousands of patients per year to their plans. The greatest challenge for home health agencies in dealing with Medicare Advantage is getting the claims paid, even when the agency has received an authorization from the plan. Challenges include, but are not limited to, lack of adequate authorization, out of network medical reviews, agencies not understanding the content of the contract and exactly what is required to get paid. Understanding the requirements for billing/payment supersede the rates that the contract promises to pay.
Learning Objectives
• Detail methods of evaluating the current process in your agency for securing MA authorizations and reauthorizations.
• Review the process of dealing with MA Plans when the agency is out of network.
• Evaluate statistics of timely filing and timely denial management.
Handout(s)
Faculty:
Michael Puskarich, MBA
Petria McKelvey
Nursing 1.0 Contact Hours awarded.
Nursing Contact Hours for this module will expire on August 1, 2024.