All Medicare providers and suppliers, including pharmacies, must not bill Medicare beneficiaries in the Qualified Medicare Beneficiary (QMB) eligibility group for Medicare Part A or Part B cost-sharing. This includes Medicare Part A and Part B deductibles, coinsurance, and copayments.
Welcome to the cultural competency in health care annual compliance training.
The Centers for Medicare & Medicaid Services (CMS) mandates all contracted providers receive basic Special Needs Plans (SNP) Model of Care training.
Between February and May, you may receive requests from us for patient medical records on behalf of our health plan partners. Health plans review these medical records for specific information to determine if the record satisfies the Eye Exam for Patients with Diabetes (EED) measure criteria for HEDIS® submission.
ECPs who want to participate in our Medicaid networks and submit claims for providing services to Medicaid members must enroll both themselves and their offices in their state’s Medicaid Program.