Today, Medicare Advantage is widespread in many parts of the country, and unfortunately, the processes for filing claims and trying to get reimbursed is not straightforward. Add another layer of complexity, a large number of Medicare Advantage Organizations (MAOs), each with their own idiosyncrasies that start with coverage issues—issues significantly different from traditional Medicare. And different coverage policies lead to problems related to claims and adjudication.
In fact, the subject is so complex, and guidance so necessary that RACmonitor is producing a two-part series on Medicare Advantage. In this session, author, educator, and consultant Duane Abbey will give you and your team a greater understanding of Medicare Advantage, paying particular attention to claims and claim adjudication.
From this webcast, you will you will gain a greater understanding of Medicare Advantage, and…
- Gain an understanding of the Medicare Advantage programs and how such programs operate.
- Learn the coverage differences between traditional Medicare and Medicare Advantage programs.
- Understand how reimbursement is conducted by Medicare Advantage.
- Learn about the appeals process when contesting claim adjudications.
- Understand the difficulties when providing services on an out-of-network basis.
Why is This Webcast Relevant?
Medicare Advantage programs are becoming more popular, and virtually all healthcare providers are already involved or will become involved with one or more programs. Understanding the differences between Medicare Advantage and traditional Medicare can translate into better reimbursement and less cost in filing and tracking claim adjudication and payment.