Unraveling Medicare Advantage Plans: Successful Tips for PT Compliance and Contract Negotiation

The Source 

Course Type: Audio Course | The Source

Presenter(s): Carmen Elliott, MS; and Gillian Russell, JD

Price: $99 Member & Members' Office Managers (must be registered by APTA member) | $169 Nonmember (subject to change)

CEU: 0.2 CEUs (2 contact hours)

Description: Nearly 10 million Medicare beneficiaries (approximately 1 in 4) have elected to join Medicare Advantage (MA) plans rather than receive services through traditional Medicare. Under Medicare Part C, private insurance companies contract with the federal government to provide a number of MA plans offering varied menus of "insurance products," such as preventive, vision, dental, and/or prescription drug coverage. Sifting through all of the coverage and cost-sharing details can be confusing for physical therapists (PT) and their patients. But there's more to consider: Although MAs are private health plans offered by private insurance companies, (and identified under a number of brand names), they are federally funded and subject to certain federal requirements. That means PTs who accept MA patients must not only adhere to the terms and conditions of each patient's specific MA plan, they must also adhere to all related federal Medicare requirements, while simultaneously negotiating fair contracts. The task can be daunting, but with a solid foundation in MA basics, PTs can do all this and more.

Purchase: View full course description at the APTA Learning Center.

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