Get proficient in fee-for-service (FFS) coverage rules
New rules require MA plans to apply FFS coverage criteria, including patient status regulations, in coverage determinations for their patients. Additionally, there are new requirements for reviews that result in a denial, as well as prior authorization guidelines.
The Live Virtual Medicare Boot Camp®—Utilization Review for Medicare Advantage Version is an intensive course focusing on the Medicare regulatory requirements for coverage determinations, including patient status. This course is designed to provide Medicare Advantage (MA) plan staff with proficiency in fee-for-service (FFS) coverage rules for application to plan patients.
This Boot Camp will help you to:
Find FFS Medicare coverage policies
Understand the difference between FFS Medicare coverage guidelines and other commercial coverage criteria
Implement compliant coverage determinations for MA plan patients
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