Providers that bill Medicare Advantage or Medicare Part C (“MA”), and most particularly capitated provider groups, should carefully watch a recent lawsuit Providers that bill Medicare Advantage or Medicare Part C (“MA”), and ...
providers for services rendered to its members. Humana’s PFFS plan pays 100% of Medicare allowable, less any applicable member copay or coinsurance amount. More on Private-Fee-For-Service How does a PFFS plan work? There is no doctor or hospital ―network‖ or directory for medical care....
000 medical providers or facilities that accept Medicare patients anywhere in the country. There are no referral requirements or pre-authorization of services to visit specialist doctors. Medicare Supplement plans are standardized, so coverage remains the same eve...