303. Getting Paid by Medicare Advantage Plans

  • Room: Julius 15/16/17/18/19
Monday, July 25, 2022: 3:50 PM - 4:40 PM
Education Credits:Course Level: Intermediate; 1 Accounting CPEs (NASBA/RE); 1 Nursing CNEs contact hours


Michael Puskarich MBA
Director - Advisory Consulting
Petria McKelvey
Precision Medical Billing


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.

This session is sponsored by Arena Analytics.


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.