RJG
Guest
I have reviewed the CMS Transmittal 1875 & the MLN Matters 6740 and understand what they are telling us for Medicare patients. My question is how are the Medicare Advantage plans handling coverage for consults? I read in the MLN Matters #6740 that this article is only for physicians billing the Medicare fee for service program it does not apply to Medicare Advantage or non Medicare insurers however I have called our BC/BS Smart Value and they told me they will be following the Medicare guidelines. I have not been able to get an answer from Humana Gold yet as to how they will handle consults. Those are the two larges Medicare Advantage plans in our area for 2010. I'm also wondering if Medicaid is planning on following CMS Medicare's guidelines. We are located in Wisconsin. Does anyone else know what the Medicare Advantage plans or Medicaid are going to do?