Planprovportal.align-360.com

Model of Care Training

Health Plan Options • Approved by Medicare • Run by Private Companies • Available across the United States • Enrolled Members Receive Services Through the Plan • All Part A and Part B Covered Services (A+B=C) • Some plans may provide additional benefits • Includes Prescription Drug Coverage (Part D) • This is known as an MA-PD

Actived: 3 days ago

URL: https://planprovportal.align-360.com/EZ-NET60PER/ConfigFiles/Model%20of%20Care%20Training.pdf

EZ-NET PROVIDER PORTAL USER GUIDE

(6 days ago) 4. Verify health plan eligibility 5. View member authorization history 6. Check status of claim/encounter information 7. Providers can access member info and member lists 8. Look up procedure codes, diagnosis codes, and other general reference information

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KeyCare Advantage Provider Manual

(6 days ago) KeyCare Advantage (“health plan” or “Plan”) is a Medicare Advantage Institutional Special Needs Plan designed to improve the care for the residents of nursing facilities in Maryland. KeyCare Advantage’s target population is an institutionalized Medicare beneficiary who resides

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2020 NHC Provider Manual

(2 days ago) NHC Advantage (“health plan” or “Plan”) is a Medicare Advantage Institutional Special Needs Plan designed to improve the care for the residents of Nursing Facilities in Missouri and Tennessee. NHC Advantage’s target population is an institutionalized Medicare beneficiary who

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Table of Contents Provider Manual

(6 days ago) Sunrise Advantage Plan (“health plan” or “Plan”) is a Medicare Advantage Plan designed to improve the care for its members in Illinois, New York, Pennsylvania, Virginia. Sunrise Advantage Plan’s target population is an institutionalized Medicare beneficiary who resides or is

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INSURED INFORMATION – ALL SECTIONS MUST BE COMPLETED

(4 days ago) •The name, address, and tax identification number of the health care provider. •The date of each service, the charge for each service, and a description of each service. •The Referral Number for specialist care if your program requires referrals from your Primary Care Physician.

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2020 PCA Provider Manual

(6 days ago) (HMO I-SNP) (“health plan” or “Plan”) is a Medicare Advantage Institutional Special Needs Plan designed to improve the care for the residents of Nursing Facilities in Texas. ProCare Advantage’s target population is an institutionalized Medicare beneficiary who

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Added care. Peace of mind Provider Manual

(2 days ago) HMO SNP) (“health plan” or “Plan”) is a Medicare Advantage Institutional Special Needs Plan designed to improve the care for the residents of Nursing Facilities in Nebraska, North Dakota, South Dakota. Great Plains Medicare Advantage’s target population is an institutionalized Medicare beneficiary who resides or is expected to reside in a

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BILLING OVERVIEW

(7 days ago) physician or other qualified health professional; use CPT 99497 for the first 30 minutes of face-to-face review with the patient, family member(s) and/or surrogate] Use add-on CPT code 99498 for each additional 30 minutes of this same service (list separately on claim in addition to code for primary procedure) 99495 99496 Transition Care

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2020 ARA Provider Manual

(2 days ago) AgeRight Advantage (“health plan” or “Plan”) is a Medicare Advantage Institutional Special Needs Plan designed to improve the care for the residents of Nursing Facilities in Oregon. AgeRight Advantage’s target population is an institutionalized Medicare beneficiary who resides

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2020 KCA Model of Care

(7 days ago) The Plan’s Health Risk Assessment Tool is a screening tool used by the Plan to: 1. Collect member self-reported health status 2. Identify potential gaps (medical, functional, cognitive, psychosocial, and mental health) in existing care and treatment plans and immediate care need 3. Monitor changes in self-reported health status on an annual basis

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Model of Care: SNF Provider Training

(3 days ago) Health Risk Assessment (HRA) : The Plan’s Health Risk Assessment Tool starts the new member assessment and care planning process for the Plan and provides an annual checkpoint and reassessment of key geriatric health metrics. Requirements: • All new Plan members receive an HRA. within 90 days of enrollment (start effective date).

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2020 SIM Provider Manual

(5 days ago) Simpra Advantage (“health plan” or “Plan”) is a Medicare Advantage Institutional Special Needs Plan designed to improve the care for the residents of Nursing Facilities in Alabama. Simpra Advantage’s target population is an institutionalized Medicare beneficiary who resides or is

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Electronic Data Interchange (EDI) Companion Guide

(8 days ago) The Health Insurance Portability and Accountability Act (HIPAA) of 1996 carries provisions for administrative simplification. This requires the secretary of the Department of Health and Human Services (HHS) to adopt standards to support the electronic exchange of administrative and financial healthcare transactions primarily

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INSURED INFORMATION

(7 days ago) •The name, address, and tax identification number of the health care provider. •The date of each service, the charge for each service, and a description of each service. •The Referral Number for specialist care if your program requires referrals from your Primary Care Physician. Complete the Attachments section.

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2020 PHP Provider Manual

(2 days ago) PruittHealth Premier (“health plan” or “Plan”) is a Medicare Advantage Institutional Special Needs Plan designed to improve the care for the residents of Nursing Facilities in North Carolina, South Carolina. PruittHealth Premier’s target population is an institutionalized

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Longevity Health Plan Provider Manual

(2 days ago) Longevity Health Plan (HMO-ISNP) and Longevity Health Plan (PPO I-SNP) (“health plan” or “Plan”) is a Medicare Advantage Institutional Special Needs Plan designed to improve the care for the residents of Nursing Facilities in Florida. Longevity Health Plan’s target population is an

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INSURED INFORMATION

(4 days ago) This form is designed to help you file a claim for health care services received by you. If a doctor, hospital, or other health care provider has already filed a claim directly with Longevity Health Plan on your behalf, please do not send a Customer Claim Form for the same services.

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Model of Care Training

(7 days ago) • Sunrise Advantage Plan is more than a health plan, we are comprehensive model of care delivery focused on best practices and innovation. Created and delivered through a unique partnership between long term care providers and care management experts.

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Simpra Billing Training

(7 days ago) Home Health Services A: Chiropractic A. Occupational Therapy Services A: Specialist N. Mental Health Services A: Podiatry N. Other Healthcare Professionals A & R: PsychiatricServices N. Physical Therapy and Speech Pathology A: Outpatient Diag. Procs/Tests/Labs A. Outpatient Diag./Therapeutic Radiology A: Outpatient Hospital A

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Simpra Advantage Model of Care Training

(6 days ago) • Simpra Advantage is more than a health plan, we are comprehensive model of care delivery focused on best practices and innovation. Created and delivered through a unique partnership between long term care providers and care management experts. The model focuses on placing decision making and caregiving in the hands of those who

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Longevity Health Plan

(4 days ago) Longevity Health Plan follows all Medicare guidelines in regard to timely filing requirement (12 months from date of service) • Cannot bill future dates of service • Bill Longevity Health Plan as you would bill Medicare in 30 day increments Acceptable claim forms: • CMS 1500 for …

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PruittHealth Premier

(4 days ago) PruittHealth Premier HMO • Contracted with CMS to provide full Medicare Benefits (Parts A, B, D) to Members • Paid monthly by CMS to provide benefits • Annual contract with CMS • Members have all Medicare rights and protections • Does not include Medicaid benefits Medicare Advantage

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PruittHealth Premier

(4 days ago) Title: PruittHealth Premier - EZ NET - Claim Form Author: AllyAlign Health, Inc. Subject: EZ NET - Claim Form Keywords: insured, patient, authorization, instructions

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Longevity Health Plan Electronic Payment Authorization

(1 days ago) This is an Agreement for electronic payments between Longevity Health Plan applicable affil DATE: SUBMISSION TYPE: NEW . CHANGE . CANCEL. MUST SELECT ONE. ACCOUNT TYPE * Return your completed EFT form via email to . [email protected] * Allow 30 days for complete processing of your EFT request.

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2020 ASC Provider Manual

(9 days ago) Align Senior Care (“health plan” or “Plan”) is a Medicare Advantage Institutional Special Needs Plan designed to improve the care for the residents of Nursing Facilities in Michigan. Align Senior Care’s target population is an institutionalized Medicare beneficiary who resides or is

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INSURED INFORMATION – Insured’s Name ( as shown on the …

(8 days ago) •The name, address, and tax identification number of the health care provider. •The date of each service, the charge for each service, and a description of each service. •The Referral Number for specialist care if your program requires referrals from your Primary Care …

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Electronic Payment Authorization Form and Agreement

(5 days ago) electronic business payments and Payee hereby directs AllyAlign Health to transmit payments to Payee’s account as designated by Payee on page 1 of this Agreement, as such information may be amended from time to time, (all information on page 1 being Payee Data) by Payee

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INSURED INFORMATION – Insured’s Name ( as shown on the …

(8 days ago) •The name, address, and tax identification number of the health care provider. •The date of each service, the charge for each service, and a description of each service. •The Referral Number for specialist care if your program requires referrals from your Primary Care Physician. If these same services were covered first by another health

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