medicare advantage plan

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    Wiki UHC SNP Program Not Paying Medicaid Portion

    We have a few patients with UHC SNP programs with this issue. UHC is processing the Medicare portion and leaving the copay/deductible to the patient and not paying the Medicaid portion. When submitted to Medicaid, they state that they have already paid UHC for contract services and that UHC is...
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    Wiki AETNA MEDICARE ADVANTAGE WWE

    I HAVE A PATIENT THAT CAME IN FOR WELL WOMAN EXAM WITH AETNA MEDICARE AND WE BILLED 99397 WITH DX Z01.419, Z12.4, AND Z11.51; THE BENEFITS QUOTED STATED WWE IS ALLOWED EVERY 12 MONTHS BUT WHEN THE CLAIM PROCESSED IT WAS DENIED FOR BENEFITS EXHAUSTED. I HAVE HAD THIS CLAIM SENT BACK 4 TIMES AND...
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    Wiki AWV and Prev code for MA plan

    Hi there, can someone please point me in the right direction on how to properly educate a medical director regarding the use of G0438/G0439 and a 9938X code on a same day visit. I believe there are very specific points of documentation that must exist in order to satisfy the submission of both...
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    Wiki Medicare Advantage plan or Dual eligibility Plan.

    Hi I am curious, patient with Medicare advantage plan Such as Medicare plus blue and Dual Eligibility plan, Should I bill to advantage plan or do I have to bill to Medicare and Medicaid after billing advantage plan. Please advise. Jinit
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    Wiki UHC Medicare Solutions denying PPD

    We are currently having an issue with UHC Medicare Solutions denying our claims for 86580 (PPD) with diagnosis code Z11.1. They are not dropping it to patient responsibility. They are telling us we must write it off. In conversations with them, they are saying we must get an ABN signed so...
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    Wiki Medicare Advantage Plans

    Our office is currently trying to figure out what to do about coding G0439, 99397, and a 99213 to Medicare advantage plans. I was not aware that the advantage plans started accepting the 99397. My supervisor and I assumed that since Medicare will not pay for 99397 that the advantage plans would...
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