 |
| Reminder: Medicare Advantage Annual Election Period and Open Enrollment Period Begins November 15, 2008 and Continues through March 31, 2009 Medicare Advantage Plans are health plan options that are approved by Medicare, but are ran by private insurance companies. They are part of the Medicare Program, and sometimes called "Part C" or Health Maintenance Organizations (HMOs). When a Medicare eligible beneficiary elects to join a Medicare Advantage Plan, the Medicare beneficiary still receives Medicare coverage; however in most cases the Medicare beneficiary must receive services from network physicians and suppliers. November 15, 2008 marks the beginning of the Medicare Advantage Annual Election Period (AEP) for Medicare beneficiaries. During the annual election period, Medicare beneficiaries may enroll in or disenroll from a Medicare Advantage Plan. The annual election period is also referred to as the "Fall Open Enrollment Season" in Medicare beneficiary publications and other resource tools. The annual election period occurs November 15 throughDecember 31 of every year. In addition to the opportunities available during the Annual Election Period, Medicare eligible beneficiaries may make one enrollment request during the Medicare Advantage Open Enrollment Period (OEP) which occurs January 1st through March 31stof every year. Note: Please refer to the CMS Internet Only Manual, Publication 100-16 Medicare Manage Care Manual for specific CMS instruction regarding the Medicare Managed Care Plans. To avoid OA-24 denials due to a Medicare Advantage Plan enrollment, suppliers are encouraged to pre-screen their new patients for Medicare Advantage Plans and re-confirm medical coverage for existing patients. The Jurisdiction B DME MAC Interactive Voice Response (IVR) system may be accessed to verify the beneficiary's eligibility. By selection option 2 (eligibility) from the main menu, suppliers can verify the Medicare Advantage Plan number, address, telephone number and effective/termination dates. The IVR can be accessed at 1-877-299-7900 Monday through Friday, from 6:00 a.m. until 7:00 p.m. Eastern Time and Saturdays from 6:00 a.m. until 3:00 p.m. Eastern Time. The Jurisdiction B DME MAC Claim Status Inquiry (CSI) is also available to assist suppliers in confirming Medicare Advantage Plans. CSI is available from 6:00 a.m. until 6:00 p.m. Eastern Time, Monday through Friday and sometimes on Saturday. Suppliers may obtain enrollment information and view the CSI manual on the National Government Services Web site at:http://www.ngsmedicare.com/ngsmedicare/DMEMAC/Claims/EDI/Enrollment_EDIDMEMAC.aspx For additional details on how to prevent ANSI OA-24 and OA-109 denials, please view the article titled "How to Prevent OA-109 Claim Denials" on the What's New Page of the National Government Services Web site at:http://www.ngsmedicare.com, then select DME MAC, accept the attestation, click on the News and Publications menu, then click on the Whats New link. |
| Remember! National Government Services' EDI List Serve is for out going messages only. Please do not respond back to messages as your response will not be answered, as this is not an authorized mode of communication at this time, Thank you! CONFIDENTIALITY NOTICE: This E-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply E-mail and destroy all copies of the original message. To unsubscribe/change profile: click here. |
Email list management powered by http://MailerMailer.com
Posts
