"These plans are designed to maximize profits for corporations, NOT to provide high-quality healthcare," said Social Security Works.A government watchdog revealed Thursday that Medicare Advantage plans—which are offered by private companies but required to follow rules set by the government healthcare program—"It couldn't be more clear that these problems are systemic and widespread in Medicare Advantage."released by the U.S.
Examples featured in the report include denying a follow-up MRI by claiming a patient's lesion was too small as well as a request for a walker from a 76-year-old with post-polio syndrome. "For an annual context, if these MAOs denied the same number of payment requests in each of the other 51 weeks of 2019," the report states,"they would have denied 1.5 million payment requests that met Medicare coverage rules and MAO billing rules that year."
RepJayapal So true. Please share.
RepJayapal 2. The federal government since the last administration permits employers to auto enroll retirees into this plan and pays the carriers more than CMS pays. Don’t believe me? Pg 3 says how they did it they permit auto enrollment
RepJayapal We are nycretirees currently in litigation with the City of NY for trying to force us into An advantage plan because the federal govt pays for it. We don’t want this. But NYCMayor thinks thinks great even after this report! This report includes AnthemInc EmblemHealth
RepJayapal Next check out the codes for the service. Many are miscoded and can be fixed by using another code. All else falls call Medicare. It can be the provider and not the Co. That needs the phone call😉 Hope it helps🙋♀️
RepJayapal Unfortunately what people don't realize is that when you get a denial First thing Appeal Write a letter to the Grevence committee. Next Don't Pay it until you have exhausted every Appeal. Even though you are on Advantage put your Medicare as Second payer. 🙋♀️
RepJayapal DBuggica Interesting read..
RepJayapal Take a look at Humana and Aetna denials! It’s ridiculous
RepJayapal The whole Medicare thing is an absolute confusing mess.
RepJayapal Ban Medicare Advantage plans. Ban the privatization of Medicare!
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