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Understanding Medicare Advantage Plans


Speaker: Bill Finerfrock, HBMA Legislative Consultant

This program discussed the types of Medicare Advantage Plans – traditional HMO, PPO type plans and private fee-for service plans and how the insurance structure affects patient coverage, service billing and provider reimbursement.

  • What is different than “regular” Medicare?
  • Are the MA plans required to provide the same coverage as the “Other” Medicare?
  • How much leeway do the MA plans have to change the rules?
  • The overall plan requirements from a National perspective Limiting charges vs. fee schedule limits
  • In-network vs. out-of-network payments
  • Determining risk areas for a practice to be considered a participating Medicare Advantage provider

A link to the Medicare Managed Care Manual is provided and was briefly discussed during this Webinar as well.

Member Price: $199.00
Non-Member Price: $249.00