Q: If I don’t have a contract with a Medicare Advantage plan, can I still get paid?
In recent months, we’ve heard from members who do not have a signed contract with a Medicare Advantage plan but receive a referral for one of their plan enrollees. An issue brief, entitled, “Medicare Advantage Plan Payment Obligations to Out of Network Providers” has been added to the LeadingAge Center for Managed Care Solutions and Innovations website under a new tab called “Issue Briefs”. This brief helps answer the question of whether and how out of network providers can be paid under the Medicare Advantage law, regulations and Medicare Managed Care Manual and includes some suggested best practices.
If you want to connect with other LeadingAge members about Managed Care, sign up for the members-only Managed Care Listserv through my.leadingage.org under Subscriptions.
