Are you aware that you will need to check each new patient to see if they are part of the
new VBID Medicare Advantage Model and if they are you will need to:
- Send out two NOE’s, one to Medicare and one to the MA Plan.
- Send out two claims, one to Medicare and one to the MA Plan.
- The 1 st year The MA Plans will work with out of network providers, future
years you will need to be in network.
- To become in network with the MA plans you will need to offer Palliative
care as this is a part of the VBID model.
- You will need to obtain authorizations from the MA plan for those patients
enrolled in MA plans that offer VBID.
- The MA plans will require more paperwork and documentation, there will
be more denials for not following “their” system and each MA plan will
have a different system.
Are you ready for the headaches that will surely happen while the MCO’s figure
out hospice billing, coding, and reimbursement?
How well has your room & board billing to the Medicaid Managed Care
Organizations been going? This is going to be just as bad if not worse.
Call Healthcare Revenue Solutions today to discuss how we can help you plan for and
let us take over all the headaches that are sure to come from this change in hospice
billing. We have been holding the Medicaid Managed Care Organizations accountable
for our client’s room and board billing and we will hold the Medicare MA plans
accountable for hospice services billing as well.