Regence Medicare Advantage Medical Policy and Review Process

Posted by:  :  Category: Medicare

Medicare Advantage Medical Policies are the property of our Plans and their affiliated or subsidiary companies, but may be used for purposes related to the health care of a Medicare Advantage Plan member.  You are strictly prohibited from using Medicare Advantage Medical Policies for purposes not related to the health care of a Plan member, including but not limited to commercial use.
Source: regence.com

Regence Medicare Advantage Medical Policy and Review Process

Medicare Advantage Medical Policies identify the clinical criteria for determining when medical services are considered ‘reasonable and necessary’ (medically necessary).  Medicare Advantage plans are required by CMS to provide the same medical benefits to Medicare Advantage members as Original Medicare.  As such, whenever possible, Medicare Advantage Medical Policies are based on Medicare coverage manuals, National Coverage Determinations (NCDs), and Local Coverage Determinations (LCDs) when available.  If there is no applicable NCD or LCD for the service under review, then other evidence-based criteria may be applied.  In addition, each member’s unique, clinical situation is considered in conjunction with current CMS guidelines.
Source: regence.com

Regence Medicare for Members 2014

Regence Advantages Value-Added Programs: Regence Advantages is a set of value-added programs that offer great savings to members. They are offered by a number of leading health-related companies. These programs include vision and hearing care services, and discounts at fitness centers. These programs are not insurance, but are offered in addition to your medical or prescription drug plan to help you stay healthy and live better. (The products and services described above are neither offered nor guaranteed under our contract with the Medicare program. In addition, they are not subject to the Medicare appeals process. Any disputes regarding these products and services may be subject to the Regence MedAdvantage grievance process.)
Source: regence.com

Regence Medicare Advantage Information Meetings

Regence BlueCross BlueShield of Utah in an HMO/PPO plan with a Medicare contract. Enrollment in Regence BlueCross BlueShield of Utah depends on contract renewal. A sales person will be present with information and applications. For accommodation of persons with special needs at sales meetings call 1-844-REGENCE.
Source: cvent.com

Regence Medicare Advantage Information Meetings

To register for a meeting, click on its underlined time link. You can view location details by hovering over the meeting time with your mouse. You can also register by calling 1-844-REGENCE (1-844-734-3623), Monday through Friday, between 8 a.m. and 5 p.m. Pacific time.  TTY users should call 711.
Source: cvent.com

Regence BlueCross BlueShield of Oregon Medicare Advantage Plans with Part D (Prescription Drug) Coverage

The following Regence BlueCross BlueShield of Oregon plans offer Medicare Advantage and Part D coverage to Oregon residents. Medicare Advantage plans, also known as Medicare Part C, are alternatives to original Medicare. These plans help cover the costs of services provided by hospitals, doctors, lab tests and some preventive screenings. These plans’ Part D component helps cover prescription drugs. Even if a plan’s monthly premium is $0, you would still pay the equivalent of the original Medicare premium. Not all plans shown here will be available to you; enter your zip code to see plans in your area. You can read about whether Medicare Advantage is right for you. If you only want plans with drug coverage, browse Prescription Drug (Part D) Plans.
Source: usnews.com

Medicare Supplement Plans & Quotes

Posted by:  :  Category: Medicare

Turning 65 is stressful, and the amount of information people receive leading up to their birthday is astounding. From the stacks of mail piling up on your desk, to the seemingly endless phone calls and quotes from insurance companies and agents, the task of gathering honest, unbiased information can feel impossible. Our goal is to offer what nobody else will, which is why we provide medicare supplement quotes, financial ratings, benefit information, application fee data, price history, and pricing methodology for all supplemental insurance companies in one clean, concise report. Our free, no obligation service is designed to give you the information you need regarding Part D and Medicare Supplement Plans in order to make an educated purchasing decision. In addition, we offer continued support for all of our customers to ensure they have no claims or billing issues. On an annual basis we review all medicare supplement insurance quotes and plan options in an effort to notify our customers of any new or better plans that may be available.
Source: medicaresupplementshop.com

Medicare Supplement Plan F

Medicare Supplement Plan F may offer expansive coverage, but it does not cover everything. Under Plan F, beneficiaries are still required to pay their Medicare Part B premium payments each month. Additionally, it is possible to have Medicare Part A without a monthly premium if the beneficiary has worked and paid Social Security taxes for at least 40 calendar quarters (10 years). Otherwise, a monthly premium for Part A coverage is also required. These costs are not covered under Medicare Supplement Plan F.
Source: ehealthinsurance.com

Compare Medicare Advantage & Supplemental Plans

Medicare Advantage insurance is offered by private insurance companies with a Medicare contract, and replaces Original Medicare Part A and Part B. You must continue to pay your Part B premiums. Medicare Advantage plans typically offer additional benefit options and have less cost-sharing than Original Medicare, and you may have to pay a monthly premium in return for the extra benefits. Medicare Advantage plans come in a variety of formats, such as HMO, PPO and PFFS plans, as well as special needs plans. Medicare beneficiaries can enroll in Medicare Advantage plans if they have Medicare Part A and Part B, but only during designated enrollment periods. These enrollment periods change from time-to-time, so please call us to get the most-up-to-date information.
Source: medicaresolutions.com

Medicare Supplement Plan F

* A benefit period begins on the first day you receive services as an inpatient in a hospital and ends after you have been out of the hospital and have not received skilled care in any other facility for 60 days in a row. ** NOTICE: When your Medicare Part A hospital benefits are exhausted, the insurer stands in the place of Medicare and will pay whatever amount Medicare would have paid for up to an additional 365 days as provided in the policy’s “Core Benefits.” During this time the hospital is prohibited from billing you for the balance based on any difference between its billed charges and the amount Medicare would have paid.
Source: bcbsil.com

Modernized Medicare Supplement Plan F for AL, AR, AZ, CO, FL, GA,
IA, ID, IL, KS, KY, LA, MD, MI, MO, MS, NC, NE, OH, NM, OK, PA, SC, TN, TX, VA & WV. Beginning 06/01/2010 &
Updated for 2011

* A benefit period begins on the first day you receive service as an inpatient in a hospital and ends after you have been out of the hospital and have not received skilled care in any other facility for 60 days in a row. ** We do not recommend The High Deductible plan F. Plan F without the high deductible is very recommended. This high deductible plan pays the same or offers the same benefits as Plan F after you have paid a calendar year $2140 deductible. Benefits from the high deductible Plan F will not begin until out-of-pocket expenses are $2140. Out-of-pocket expenses for this deductible are expenses that would ordinarily be paid by the policy. This includes the Medicare deductibles for Part A and Part B, but does not include the plan’s separate foreign travel emergency deductible.
Source: themedicarechannel.com

Medicare Supplement Plan F

Under Fire: Many politicians and health economists believe plan F should be eliminated or modified because it provides first dollar coverage for people who purchase the plan. They believe people who do not have co-payments or deductibles to pay use medical services more often, which hurts the Medicare system as there are more claims submitted. There have been many attempts by various political figures to modify these plans by adding co-payments or a small deductible. However, a study completed by the National Association of Insurance Commissioners found people who have plans that offer first dollar coverage (Plan F & Plan C) do not seek more medical services than those who have a co-pay or deductible. For now, it seems Medicare Supplement F is safe.
Source: medicaresupplementshop.com

Medicare.gov: the official U.S. government site for Medicare

Posted by:  :  Category: Medicare

The page could not be loaded. The Medicare.gov Home page currently does not fully support browsers with "JavaScript" disabled. Please note that if you choose to continue without enabling "JavaScript" certain functionalities on this website may not be available.
Source: medicare.gov

Welcome to Maine Medicare Options!

The benefit to you is that I am a “One-Stop Shop.”   When you sit down with me we will review your specific needs and match you up with the plans that best meet those needs.  I will help you narrow down those choices to one plan by answering all your questions so you can make the best choice for you and feel confident knowing that you have chosen the right plan.  I will also help you enroll in the plan and as your agent, I will be there with you during the entire process of enrollment.  I am also available to you during the year any time you have questions or need direction.  Medicare is very complex and it is a great relief to know you have someone in your corner every step of the way.   Every year Medicare Advantage and Part D Prescription Drug plans can change and as your agent, I will talk with you or meet with you before your plan changes.  We will review all changes and if necessary help you to find a new plan that suits your needs best.  I will never pressure you or suggest you change plans.  That decision is always yours to make.   I am simply here as a guide to help you make an informed decision.  I am well respected among my peers and maintain a good reputation. I build meaningful relationships with the people I meet and offer exceptional customer service.
Source: mainemedicareoptions.com

2015 Maine Medicare Part D Prescription Drug Plan Highlights www.Q1Medicare.com

Coverage Gap the Donut Hole: In the CMS Standard Plan, the beneficiary must pay the next $3720 in drug costs (the Donut Hole). The Healthcare Reform provides that for Plan Year 2015, ALL formulary generics will have at least a 35% discount and ALL brand drugs will have at least a 55% discount in the coverage gap. The Gap Coverage Types discussed in this section are in addition to the Healthcare Reform mandated discounts. In our chart, you will see one of the following:
Source: q1medicare.com

Medicare Billing Training and Education Program Summaries

Posted by:  :  Category: Medicare

Associate degrees in medical billing and coding may be earned nationwide, often through online degree programs. The comprehensive curriculum trains students in computer technology, insurance industry issues, administrative functions and the submission of medical claims. Medicare law and billing practices are discussed and compared to Veterans Affairs, private, state and federal insurances to give a broad-spectrum overview of the various reimbursement practices in place. A high school diploma is usually the only prerequisite for entering an associate degree program.
Source: education-portal.com

Medicare DME: Documentation, Billing and Collections training

MEDICARE DME REIMBURSEMENT The nation’s population is aging dramatically thanks to the Baby Boomers. Approximately 8,000 to 10,000 Americans turn 65 EVERY DAY and this trend is projected to continue through the next decade. This should spell nothing but opportunity for DME providers to the tune of 14% estimated annual growth. There are, however, forces working against today’s DME providers that make it increasingly harder to compete and stay compliant, the most dramatic being COMPETITIVE BIDDING. This, coupled with waves of CERT, RAC, ZPIC and DMEMAC audits, PECOS, accreditation, compliance, ICD-10, and increased cost of goods will force most DME providers to find new and innovative ways to decrease their dependency on Medicare to shore up their bottom line and remain profitable. Today’s DME provider faces the challenge of providing low cost, high quality services while maintaining compliance with all federal, state, local, and corporate regulations. This course will not only cover the entire reimbursement process from intake and insurance verification to billing and accounts receivable management, but will also outline time-proven methods to distance DME providers from Medicare as well as maximizing revenue with a provider’s current patient base. Participants will also receive in-depth information on the latest changes affecting the Home Medical Equipment industry and strategies to react to them while maintaining a viable and profitable DME company.
Source: findaseminar.com

Medicare and Medicaid Billing Training Programs

You may be able to boost your career prospects by qualifying for the American Health Information Management Association’s (AHIMA) Registered Health Information Technician (RHIT) designation. This certification requires graduation from a 2-year associate’s degree program accredited by the Commission on Accreditation for Health Informatics and Information Management Education and passing an AHIMA qualifying test. The American Academy of Professional Coders also offers specialized certifications, including the Certified Professional Coder-Payer (CPC-C) designation.
Source: degreedirectory.org

Getting Paid: Billing Medicare for Diabetes Self

Copyright © 2001 by the American Academy of Family Physicians. This content is owned by the AAFP. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. Contact fpmserv@aafp.org for copyright questions and/or permission requests.
Source: aafp.org

Medicare Billing: Wheelchairs, Scooters, Lift Chairs

We understand that the process of submitting claims to Medicare can be difficult and time consuming. To help make the process easier, SpinLife offers what is known as “courtesy billing”. This means that after you purchase an eligible product from SpinLife and request at checkout that we courtesy bill Medicare, we send you all of the documentation required by Medicare for you to complete with your physician. Once medically qualifying documentation is submitted into SpinLife, we can submit a claim to Medicare on your behalf. If your claim is approved by Medicare, they will reimburse you directly for their portion of your claim via mail.
Source: spinlife.com

Process of Medical Billing for Medicaid & Medicare

You will process claims associated with Part A of Medicare (medically necessary services) if you’re a medical billing specialist working with hospitals, clinics, and other facilities that offer inpatient care. You file Part A claims on behalf of your provider using the UB-04 medical claim form (also known as the CMS-1450 form). The UB-04 is the uniform institutional provider hardcopy claim form accepted for billing third-party providers. It is also the only hardcopy claim form that CMS accepts from institutional providers such as hospitals or skilled nursing facilities. When filing the UB-04 form, you should note that not all payers are required to complete the same data fields. Do your research to determine what fields are appropriate for each claim.
Source: medicalbillingandcodingonline.com

ConnectiCare VIP Medicare Insurance

Posted by:  :  Category: Medicare

LIFESTYLE Do you want the option to seek medical services outside our network? Do you spend extended periods of time away from home? Consider our VIP Option (HMO-POS) Plans. These Plans offer the flexibility to receive care nationally from Medicare-approved doctors and hospitals. PRESCRIPTION DRUG COVERAGE Do you need coverage for your prescriptions? All Plans include Prescription Drug Coverage, except the VIP Prime 4 (HMO) Plan. If you have creditable Prescription Drug Coverage from a previous employer, or from the Veterans Administration (VA), our Prime 4 Plan may be a good option for you. ADDITIONAL SAVINGS Do you wear glasses or contacts? Our Vision Discount Program may be able to save you hundreds of dollars each year. Do you frequently fill prescriptions? Our Preferred Pharmacies and Home Delivery (Mail-Order) Pharmacy can offer both convenience and savings. DENTAL NEEDS Will you need dental care? Our optional Dental Plan offers you a great value. You’ll get both preventive and comprehensive services for an additional low monthly premium.
Source: connecticare.com

ConnectiCare VIP Medicare Insurance

You may enroll in a ConnectiCare VIP Medicare Advantage Plan only during specific times of the year. Here are some important enrollment dates: Initial Coverage Election Period You can enroll when you first become eligible for Medicare (three months before you turn 65 until three months after the month you turn 65). If you did not elect Part B when you were first eligible, you can still enroll in a Medicare Advantage Plan. You will have a three month period to enroll which begins three months before your Medicare Part B effective date. You will not be able to enroll after your Medicare Part B effective date. If you get Medicare due to a disability, you can join from three months before to three months after your 25th month of disability. Please Note: You must qualify for Medicare Part A and be enrolled in and continue to pay for Medicare Part B to be eligible. Annual Election Period for 2015 Coverage: October 15, 2014 – December 7, 2014 If you are eligible for Medicare, you can enroll in or switch plans during the Annual Election Period. For example, you can switch from Original Medicare to a Medicare Advantage plan (like a ConnectiCare VIP Medicare Plan). Your coverage will be effective on January 1, 2015. Special Enrollment Period In certain situations, you may be able to join, switch, or drop a Medicare Advantage plan at other times during the year. Some of these situations include the following:
Source: connecticare.com

Compare Medicare Advantage & Supplemental Plans

Medicare Advantage insurance is offered by private insurance companies with a Medicare contract, and replaces Original Medicare Part A and Part B. You must continue to pay your Part B premiums. Medicare Advantage plans typically offer additional benefit options and have less cost-sharing than Original Medicare, and you may have to pay a monthly premium in return for the extra benefits. Medicare Advantage plans come in a variety of formats, such as HMO, PPO and PFFS plans, as well as special needs plans. Medicare beneficiaries can enroll in Medicare Advantage plans if they have Medicare Part A and Part B, but only during designated enrollment periods. These enrollment periods change from time-to-time, so please call us to get the most-up-to-date information.
Source: medicaresolutions.com

Medicare Advantage Customer Service Rankings

Consumer assessment scores for drug plans are numbers between 0 and 100 (higher is better) based on enrollee responses to the following questions: In the last 6 months, how often did your health plan’s customer service give you the information or help you needed about prescription drugs? In the last 6 months, how often did your plan’s customer service staff treat you with courtesy and respect when you tried to get information or help about prescription drugs? In the last 6 months, how often did your health plan give you all the information you needed about which prescription medicines were covered? In the last 6 months, how often did your health plan give you all the information you needed about how much you would have to pay for your prescription medicine? For health plans, a similar set of questions is asked in the consumer assessment: In the last 6 months, how often did your health plan’s customer service give you the information or help you needed? In the last 6 months, how often did your health plan’s customer service treat you with courtesy and respect? In the last 6 months, how often were the forms for your health plan easy to fill out? Call center hold times were truncated to ten minutes for calls in which the call surveyor was on hold for at least ten minutes. Information on consumer assessment scores for health and drug plans comes from the CMS documents “Medicare 2014 Part C & D Display Measure Technical Notes” last updated December 12, 2013 and “Medicare 2014 Part C & D Star Rating Technical Notes” last updated April 2, 2014.
Source: healthpocket.com

Your Medicare Supplemental Insurance Information – MedicareSupplemental.com

Posted by:  :  Category: Medicare

There are exceptions to the standardization if you live in certain states, such as Massachusetts, Minnesota, and Wisconsin. Depending on your state, you may be able to buy another type of Medigap policy called Medicare SELECT (a Medigap policy that requires you to use specific hospitals and in some cases specific doctors to get full benefits). Who Provides Medicare Supplemental Insurance? Medicare supplemental insurance is provided by private insurance companies such as AARP, BlueCross BlueShield, Globe Life, Humana, Mutual of Omaha, Transamerica Life, United American, UnitedHealthcare and many others. Remember from above that Medigap insurance companies can sell you only a “standardized” Medigap policy. All Medigap policies must have specific benefits so you can compare them easily on the basis of price.
Source: medicaresupplemental.com

Compare Medicare Advantage & Supplemental Plans

Medicare Advantage insurance is offered by private insurance companies with a Medicare contract, and replaces Original Medicare Part A and Part B. You must continue to pay your Part B premiums. Medicare Advantage plans typically offer additional benefit options and have less cost-sharing than Original Medicare, and you may have to pay a monthly premium in return for the extra benefits. Medicare Advantage plans come in a variety of formats, such as HMO, PPO and PFFS plans, as well as special needs plans. Medicare beneficiaries can enroll in Medicare Advantage plans if they have Medicare Part A and Part B, but only during designated enrollment periods. These enrollment periods change from time-to-time, so please call us to get the most-up-to-date information.
Source: medicaresolutions.com

Medicare Supplement Plans & Quotes

Turning 65 is stressful, and the amount of information people receive leading up to their birthday is astounding. From the stacks of mail piling up on your desk, to the seemingly endless phone calls and quotes from insurance companies and agents, the task of gathering honest, unbiased information can feel impossible. Our goal is to offer what nobody else will, which is why we provide medicare supplement quotes, financial ratings, benefit information, application fee data, price history, and pricing methodology for all supplemental insurance companies in one clean, concise report. Our free, no obligation service is designed to give you the information you need regarding Part D and Medicare Supplement Plans in order to make an educated purchasing decision. In addition, we offer continued support for all of our customers to ensure they have no claims or billing issues. On an annual basis we review all medicare supplement insurance quotes and plan options in an effort to notify our customers of any new or better plans that may be available.
Source: medicaresupplementshop.com

Best Medicare Supplement Insurance Quotes

Every Medicare supplemental insurance plan must follow federal and state laws designed to protect you. Medicare supplement plan insurance companies can only sell you a “modernized” Medicare supplemental insurance plan identified by letters A through N. Each modernized Medicare supplemental insurance plan must offer the same basic benefits, no matter which insurance company sells it.
Source: medicaresupplementplans.com

Medicare Supplement Insurance Quote Engine

In addition to Medicare supplement insurance, we are pleased to be participating in the Medicare Advantage market. The Medicare Advantage policy is a low cost alternative to a Medicare supplement policy and is especially advantageous for those less than 65 years old. The Private Fee For Service (PFFS) is a type of Advantage plan that allows Medicare recipient to visit any doctor, any hospital, anywhere. Therefore, many Medicare recipients are well served by the lower cost Private Fee For Service plan.
Source: bestmedicaresupplement.com

Medicare Supplemental Insurance

Finding the best Medicare Supplemental insurance, Medicare Advantage, and Medicare Part D has gotten more complicated nearly every year. In 2010 Medicare Supplement Insurance added 2 new plans Medigap plan N and Medigap Plan M. At the same time they eliminated several other Medicare Supplement options. Medicare Advantage insurance plans redefine benefits and premiums every year. And, with future Medicare subsidies uncertain due to changing regulation from healthcare reform who can keep up. For many individuals Medicare Supplement Insurance is becoming the best option. Unfortunately, comparing Medicare Supplemental Insurance Plan premiums (Medigap) and Medicare Advantage plans can be a time consuming endeavor. Our highly trained insurance advisors can explain all of your supplemental Insurance options, and assist in finding the best Medicare supplement and Medicare Part D combination that best fits your specific needs. With all the options affecting Supplement insurance and Part D it makes sense to have an expert assist you through the maze.
Source: mysenioradvisorsgroup.com

What’s Medicare Supplement Insurance (Medigap)?

Some Medigap policies also offer coverage for services that Original Medicare doesn’t cover, like medical care when you travel outside the U.S. If you have Original Medicare and you buy a Medigap policy, Medicare will pay its share of the Medicare-approved amount for covered health care costs. Then your Medigap policy pays its share.
Source: medicare.gov

Medicare Supplemental Health Insurance Information and Medicare Supplement Insurance Plans

Unlessyou buy a Medicare SELECT policy, you may go to any doctor or hospitalfor treatment. The Medicare supplemental insurance policy pays for itsshare of the expenses and your Medicare policy covers its share. Thelevel of benefits you receive will depend on which plan you choose. Youwill pay for your Medicare supplemental insurance and pay the Medigap insurancecompany on a separate invoice. You will receive a Medicare Summary oncea month by mail and your Medigap insurance company will also send you Medicare health insurance planinformation on what has been paid. A Medicare supplemental health insurance policy doesnot replace your original Medicare coverage. It simply provides additional benefits to help cover themedical expenses that are not paid for by the original Medicare policy.You may also want to join a Medicare Advantage Health Plan that willhelp with drug costs and coinsurance deductibles.
Source: healthinsurancefinders.com

Extra Benefits & Discounts for SummaCare Medicare Members

Posted by:  :  Category: Medicare

Enjoy free access to participating gyms and fitness/wellness centers. Take advantage of this program by showing your SilverSneakers or SummaCare member ID card to get started at one of the many locations in our service area. Many of the group exercise classes are designed with seniors in mind. Find a participating fitness location near you.
Source: summacare.com

SummaCare Career Opportunities

Claims Processor (2 positions) Configuration Specialist I (2 positions) Configuration Specialist, Provider I (2 positions) Customer Service Representative I Customer Service Representative III Customer Service Representative III – Bilingual Mail Processor Manager, Formulary & Pharmacy Benefits Medicare Compliance Coordinator (2 positions) Medicare Compliance Officer Programming Analyst, Finance Project Specialist, Medicare Quality Assurance Coordinator Records Review Nurse Sr. Medicare Retention Specialist Web Solutions Analyst
Source: summacare.com

AmeriChoice Medicare Plans

Posted by:  :  Category: Medicare

AmeriChoice is one of the nation’s leading providers in Children’s Health Insurance Programs, Medicaid, and Medicare policies, serving over three million people throughout the United States. A subsidiary of the UnitedHealth Group, AmeriChoice provides public sector health care and powers various other state health plans. UnitedHealth Group has served millions of Americans since the 1970s, providing innovative coverage and also offering the first network health insurance policy for seniors. The relationship between AmeriChoice and UnitedHealth ensures high quality coverage and policies to its members. AmeriChoice serves members in 25 states and Washington, DC.  They also provide Management Service Organizations (MSO) in California and Georgia. In 2008, AmeriChoice acquired Unison Health (based in Delaware, Ohio, Pennsylvania, South Carolina, Tennessee, and Washington, DC), expanding its coverage across the United States.  
Source: medicaresolutions.com

Rutgers New Jersey Medical School

May issue referrals using script (note on physician letterhead also acceptable). Info which must be included in referral: Patient name, address, and DOB; PCP name, telephone number, and UHC Community Plan_Americhoice ID#; Specialist name, address, telephone number, and UHC Community Plan_AmeriChoice ID #; and list of all requested services including frequency and duration.
Source: rutgers.edu

UnitedHealthcare Health Insurance

Insurance products and services offered are underwritten by All Savers Insurance Company, Health Plan of Nevada, Inc., UnitedHealthcare Community Plan, Inc., UnitedHealthcare Insurance Company, UnitedHealthcare of Alabama, Inc., UnitedHealthcare of Florida, Inc., UnitedHealthcare of Louisiana, Inc., UnitedHealthcare of the Mid-Atlantic, Inc., UnitedHealthcare of the Midwest, UnitedHealthcare of Mississippi, Inc., UnitedHealthcare of New England, Inc.,  UnitedHealthcare of New York, Inc., UnitedHealthcare of North Carolina, Inc., UnitedHealthcare of Ohio, Inc., UnitedHealthcare of Pennsylvania, Inc., Oxford Health Plans (NJ), Inc.
Source: uhc.com

Perot Systems to Provide DIAMOND Solutions for AmeriChoice’s Health Plans

DALLAS, Sept. 24 /PRNewswire/ — Perot Systems Corporation (NYSE: PER) and AmeriChoice Health Services, Inc. announced today a license and implementation agreement for Perot Systems DIAMOND(R) 950 health benefits administration system software. Perot Systems will implement DIAMOND 950 and perform business process reengineering services for all lines of business throughout AmeriChoice’s three health plans and for any future expansion. “After thoroughly evaluating the best benefits administration solutions in the market, we chose Perot Systems to provide us with their fully functional, scalable DIAMOND platform and the business process reengineering services needed to streamline operations throughout our operations,” said Jess Sweely, COO of AmeriChoice. Chuck Lyles, Perot Systems vice president and Healthcare Industry leader, said, “This complete technology and business solution provides a standard system configuration and a streamlined workflow across all of AmeriChoice’s health plans.” DIAMOND 950 will process Medicaid, Medicare Plus Choice, Child Health Insurance Program and other public sector healthcare program claims for AmeriChoice’s constituents, while giving them: — Comprehensive, fully integrated functionality — Proven scalability — Interoperability At the heart of the DIAMOND client/server architecture is the Oracle(R) relational database. Oracle’s open and flexible architecture gives DIAMOND 950 the secure, reliable foundation needed to handle the large transaction volumes that are increasingly required today. DIAMOND 950 yields SQL accessibility and high performance. Plus, DIAMOND 950’s graphical user interface also makes it easy to learn and use. About AmeriChoice AmeriChoice Health Services (ACHS), of Vienna, VA, provides an array of specialized services to its health plans, including finance, internal audit, legal, corporate compliance, information systems, human resources, public affairs, facilities management, telecommunications and health services. AmeriChoice operates its own health insurance plans, serving more than 360,000 beneficiaries of government healthcare programs in Pennsylvania, New York, and New Jersey and provides management and information technology services to other managed care organizations. About Perot Systems Perot Systems is a worldwide provider of information technology services and business solutions. Through its flexible and collaborative approach, Perot Systems integrates expertise from across the company to deliver custom solutions that enable clients to accelerate growth, streamline operations, and create new levels of customer value. Headquartered in Dallas, Texas, Perot Systems has more than 400 clients and reported 2000 revenue of $1.1 billion. The company has more than 8,000 Associates located in the United States, Europe, and Asia. Additional information on Perot Systems is available at http://www.perotsystems.com PEROT SYSTEMS, the perotsystems logo and DIAMOND are registered trademarks of Perot Systems Corporation or its subsidiaries in the United States and/or other countries. Oracle is a registered trademark of Oracle Corporation in the United States and/or other countries. All other trademarks used here are the property of their respective owners. Statements contained within this press release may contain forward-looking statements, which involve risks and uncertainties that may cause actual results to vary from those contained in the forward-looking statements. In some cases, you can identify such forward-looking statements by terminology such as “may,” “will,” “could,” “forecasts,” “expects,” “plans,” “anticipates,” “believes,” “estimates,” “predicts,” “potential,” or “continue.” In evaluating all forward-looking statements, you should specifically consider various factors that may cause actual results to vary from those contained in the forward-looking statements, such as: the loss of major clients; changes in its UBS relationship and variability of revenue and expense associated with its largest customer; growing start-up businesses; the highly competitive market in which Perot Systems operates; the variability of quarterly operating results; changes in technology; and risks related to international operations. Please refer to the Perot Systems Annual Report on Form 10-K for the fiscal year ended December 31, 2000, as filed with the U.S. Securities and Exchange Commission and available at www.sec.gov, for additional information regarding risk factors. Perot Systems disclaims any intention or obligation to revise any forward-looking statements whether as a result of new information, future developments, or otherwise. MAKE YOUR OPINION COUNT – Click Here http://tbutton.prnewswire.com/prn/11690X76416428 SOURCE Perot Systems Corporation
Source: prnewswire.com

Medicare Supplement Plan G

Posted by:  :  Category: Medicare

The majority of Medicare Supplement plans do not cover Part B excess charges, which is why Plan G may be of interest for those with frequent medical needs. Excess charges are additional expenses incurred outside of the Medicare-approved charge. For example, if Medicare’s allowed charge for a doctor’s appointment is $100, the physician may choose not to accept that amount, electing instead to charge an additional 15% for the appointment. In this instance, Medicare would pay 80% of the allowed charge, sending the physician $80. The beneficiary would then be responsible for paying not only the remaining $20, but also the excess 15% charge, another $15, making the total out-of-pocket cost $35. Because Plan G covers the Part B excess charges, all of the out-of-pocket costs in this example are covered by this policy.
Source: ehealthinsurance.com

Medicare Supplement Plan G

The reason why Medicare Supplement Plan G is more favorable many times is due to the fact that, on average, the Supplemental Plan G costs approximately $20 – $25 less per month than the more comprehensive Plan F, thus saving roughly $240 – $300 per year. With the only difference between Plan G and Plan F being the annual Medicare Part B Deductible ($140 in 2012), the premium savings on Plan G usually outweigh the additional cost of paying for the Plan F, and you can still enjoy virtually all of the same benefits.
Source: medicaresupplementsolutions.com

Medicare Supplement Plan G

* A benefit period begins on the first day you receive services as an inpatient in a hospital and ends after you have been out of the hospital and have not received skilled care in any other facility for 60 days in a row. ** NOTICE: When your Medicare Part A hospital benefits are exhausted, the insurer stands in the place of Medicare and will pay whatever amount Medicare would have paid for up to an additional 365 days as provided in the policy’s “Core Benefits.” During this time the hospital is prohibited from billing you for the balance based on any difference between its billed charges and the amount Medicare would have paid.
Source: bcbsil.com

Medicare.gov: the official U.S. government site for Medicare

Posted by:  :  Category: Medicare

The page could not be loaded. The Medicare.gov Home page currently does not fully support browsers with "JavaScript" disabled. Please note that if you choose to continue without enabling "JavaScript" certain functionalities on this website may not be available.
Source: medicare.gov

Handbooks, Forms and Notices

Families will have the opportunity to print the forms, fill them out at home and return them to their child’s school. Please click on the links below to read the Forms and Notices Handbook, then to print out each form. Please sign the forms and return them to your child’s school.
Source: nc.us

Medicare Form, Medicare Forms

Aetna Medicare Basic Plan (HMO) will not be renewing its Medicare contract effective January 1, 2012. You may choose to enroll in our plan, but your coverage will automatically end on December 31, 2011 in Atlantic, Burlington, Camden, Cumberland, Gloucester, and Salem counties in New Jersey. Because this plan ends on December 31, 2011, if you decide to join, you are entitled to enroll in a new MA plan or PDP beginning December 8, 2011 through February 29, 2012. However, if you want your enrollment in the new plan to take effect on January 1, 2012, the new plan must receive your application by December 31st. You may also have the option of enrolling in a Medicare Cost Plan, if one is offered in your area. If you do not enroll in another MA plan, Medicare Cost Plan or PDP plan by December 31, 2011, you will be disenrolled from our plan and enrolled in Original Medicare on this date. You will receive additional information in the fall about your rights and additional options.
Source: aetnamedicare.com